Hand Hygiene Project in the Hospital
Hand hygiene is a practice necessary for ensuring proper healthcare and safety among patients and heath care providers in hospitals. In attending to their patients, nurses and other hospital staff enter their rooms. They may be directly in contact with the patient, such as in giving medicine and food, or not. It is attested that in this way, people inside the room or even in the hospital premises could adversely affect one another. In the mid-1800’s, hospitals were identified to have acquired diseases transferred through the hands of the health care workers (McDonald & May, 2011). Having these infections is serious as they can lead to more severe diseases – even those that lead to death. For instance, there is an estimate of 150,000 healthcare acquired infections (HCAI) that contribute to 7,000 deaths each year in Australia (Victorian Government Health Information, 2010). Observing proper hand hygiene in hospitals can significantly prevent these infections among patients and other individuals in the hospital. The scope of this project is having collaboration between patients and healthcare givers in preventing healthcare acquired infections, thus leading into a safe and quality healthcare.
As aforementioned, patients in hospitals are given proper healthcare either by direct contact or not. Nurses attend to their patients by giving medicine and food, or by helping them sit, stand, or walk around. Nurses may not directly touch their patients but may touch other things before the patient or a family member with him/her takes it. So in one way or another, healthcare providers gain contact with their patients – either directly or indirectly. Also, healthcare givers can still transmit such infections despite having gloves. Contaminated objects include endotracheal tubes, suction equipment, urinary collection units, thermometers, rectal tubes, bed linens, and waste containers (Lankford et al., 2003). Now it is certain that hospital have faucets and hand washing units. However, people still forget about it. Some think that they will not directly touch patients when they go inside the rooms. But of course, they are obliged to give things to their patients whenever they ask. The problem comes when they [the healthcare workers] forget that their hands are not washed. In another case, healthcare workers admit that since they go in and out of patients’ rooms and work on many things, hand hygiene is often neglected. These issues should be dealt with accordingly, by implementing proper ways to make hand washing permanently and consciously observed in hospitals.
Hospitals around the world that sought compliance with having hand hygiene as a way for proper healthcare provision adopted certain procedures throughout the project. First, a memorandum is created, having all staff engaged in the ‘hand hygiene campaign’. Doctors, nurses, and staffs (i.e. janitors, receptionists, and others) are made aware of their responsibility and accountability in securing the health of their patients. In relation to this, education regarding the importance of hand hygiene and the ways of compliance is provided for all the workers. In the case of the University of Geneva Hospitals, located in Switzerland, compliance with the campaign significantly improved following a hospital-wide education program (Pittet et al., 2000). Second, the theme for the campaign is promoted in the entire hospital. Patients, family members, and visitors are also informed and instructed about the project. Third, sanitizers are introduced in more areas of hospitals and their visibility was increased. For some, water-and-soap units were replaced by alcohol-based hand sanitizers; others adapted other solutions like STERIS foam. Medium to large sized posters are also placed near hand sanitation units. Either in rooms or in the hallways, these helps remind everyone of the campaign. Fourth, patients, family members, and visitors are reminded to collaborate with the hospital staff. For every person who enters patient’s room, the patient or the person(s) with him/her is encouraged to ask the staff if they already washed their hands. Other hospitals required their staff to wear clothing with a slogan “Ask me if I washed my hands”. This will also remind the patients to persistently remind the staff to comply with the project. Lastly, hospitals assign observers in a routine manner and surveys are also given to the patients, family members, and visitors. These observers follow the healthcare worker who enters into a patient room (Lankford et al., 2003). This gives awareness to the healthcare staff in a higher level. Also, after each activity done in a patient’s room, surveys are given in order to monitor how healthcare givers comply with the campaign.
Reports in many hospitals suggest that such high demand for proper hand hygiene is associated with low compliance (Pittet et al., 2000). Others think that having hand hygiene units placed near the bed of the patients will be effective. However, some does not find it wholly effective. Barriers to proper hygiene may include one of more the following: hand hygiene agents irritate and dry skin; patient needs take priority over hand hygiene; sinks are inconveniently located; glove use dispenses with the necessity of additional hand hygiene; healthcare workers have inadequate knowledge of instructions and protocols for hand hygiene; there is lack of role models in superiors and peers; there is lack of recognition of the diseases associated with lack of proper hand hygiene; or simply unawareness (Pittet, 2000).
The effectiveness of this project lies in having higher level of awareness both of the patients and the healthcare providers. Hospitals should seek for every practical way possible for this. Hospitals may even employ automated units at the door of every room, reminding every healthcare giver before entering. In generalization, the goal of campaign is not merely to put hand hygiene units throughout the hospital but to engage the healthcare providers as individuals responsible and accountable for the health of their patients. Certain barriers may be present throughout the project. Nevertheless, the cost of such barriers is absolutely not as hard as when infections are not prevented due to lack of proper hand hygiene.
References
Lankford, M., Zembower, T., Trick, W., Hacek, D., Noskin, G., & Peterson, L. (2003). Influence of role models and hospital design on hand hygiene of health care workers. Emerging Infectious Diseases, 9(2), 217-223.
McDonald, C. & May, C. (2011). Hand hygiene Harrison Medical Center Improvement project [PDF document]. Retrieved from http://www.wapatientsafety.org/downloads/1103_Hand_Hygiene_Webinar_C_May.pdf
Pittet, D., Hugonnet, S., Harbarth, S., Mourouga, P., Sauvan, V., Touveneau, S., & Perneger, T. (2000). Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet, 356, 1307-1312.
Pittet, D. (2000). Improving compliance with hand hygiene in hospitals. Chicago Journals, 21(6), 381-386.
Victorian Government Health Information (2010). Hand hygiene project. Retrieved from http://www.health.vic.gov.au/qualitycouncil/activities/handhyg.htm
