Free Essay Sample: Health Care Problems - Informed by Evidence-Based Practice (EBP)

Hand hygiene as a term implies the use of water or an antimicrobial with soap or solution on the surface of the hands to clean out dirt and germs. Hand hygiene education might be considered simple, but its practice could help curb a lot of germs spreading. Research has revealed that healthcare providers averagely clean their hands only half the times they are expected to clean them. Statistically, one out of twenty-five patients in a hospital has an infection which can be associated with healthcare in a given day (Luangasanatip, 2015). If practiced effectively, hand hygiene could help prevent infections associated with healthcare. So now the question is, why wash hands? The simple answer to that is to avoid is to avoid contacting illnesses or spreading them to other parties.

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Germs can get into the hands so easily. A gram of faeces is believed to contain an approximate of one trillion germs. Human or animal faeces can contain germs that cause diarrhoea and adenovirus, which is a respiratory disease, like norovirus, salmonella and E. coliO157 (Luangasanatip, 2015). Such germs could be acquired into our arms in obvious ways like after using the toilet or changing a diaper. Therefore hand washing education helps in maintaining the health of people and the community at large. Statistics have shown that cleaning hands could help reduce the risks of diarrhoea infections by 31% and respiratory diseases by 21% (Luangasanatip, 2015).

World Health Organization (WHO) has been one of the leading entities in promoting health all over the world. Some of the hygiene moments they have improved include the following. Washing hands before getting into contact with patients, washing hands before carrying out aseptic procedures on patients, cleaning hands after being exposed to body fluids and after getting into contact with patients or their surroundings are some of the hygienic improvements (Luangasanatip, 2015). Studies have also been carried out to demonstrate that hand hygiene in compliance with healthcare wastes is an effective intervention. World Health Organizations has used multimodal strategies like audits, reminders, feedback from the performance, and improvement of water, availability of soap and healthcare wastes. They have also installed automated sinks and introduced hand rubs which are made out of alcohol as well as improving the safety of the institution.

The products made for the hygiene of hands have been spread widely in so many forms that they meet each clinical need in the environment of healthcare. Such agents include alcohols, chloroxylenol, chlorhexidine, plain soap, iodine, hexachlorophene and many others (Luangasanatip, 2015). Whenever it comes to the techniques of hand washing, it has been conventionally standard to use water and detergents. Rubbing alcohols in forms of foams, wipes and gels can also be applied. Whenever selecting the type of agent to use it is advisable to consider its safety, efficiency and how it can comply both with the patient and the healthcare worker. Several factors are to be considered including; the cost, the ease of using, the reactions with the skin, the efficacy, its availability and how easy it can be accessed around the healthcare facility.

Healthcare hygiene has greatly affected the world community for a so long. In the 1800's Ignaz P. Semmelweis, a physician introduced hand hygiene. Deaths in postpartum women were rampant except for when physicians washed their hands before delivering the babies (Luangasanatip, 2015). The idea was ridiculed for a long time by many people and fellow practitioners in the medical field but as times went by, centuries even, the idea became more palatable. It became evident that with all the machinery and technologies available, the mere failure to wash hands may nullify the effectiveness of the tools. So many guidelines have been put into place as well as monitoring and protocols assessing of the quality of the hygiene in hospitals, but multiple papers have shown that only 50% - 60% of the hospitals adhered to the rules. However, it is not to be said that the WHO guidelines in 2009 did not bring about a change (Luangasanatip, 2015).

For individuals, healthcare workers have been believed to be so busy to take into consideration their hand hygiene. The status of their patients and the things overwhelming them around the hospital environment hinders the healthcare workers to develop a hand hygiene habit. Patients, on the other hand, have backgrounds that get impacted whenever it comes to the topic of hand hygiene. Within the WHO framework, a Task Force was created on the aspects of culture and religion just in cases of attitudes towards the practice. Taking a close look at the some of the major religions in the world; for the Muslims, they are required to maintain a high level of hygiene five intervals in a day. For the Catholics, the holy water is sprinkled to on hands before the holy communion of bread and wine and the value of cleaning hands after touching the holy oil. However, the Christians have their hygienic behaviour more inclined spiritually.

PICO Table

P(patient/problem) Hospital acquired infections by patients through Healthcare Workers.

I(intervention/indicator) Hand washing to maintain hand hygiene among HCWs

C(comparison) No hand washing with mare water and soap. Instead alcoholic solutions in from of gels, foams or wipes.

O(outcome) Reduced infections by germs like salmonella on individuals and communities at large.

Keywords used for the search

When I was searching for literature review, I utilized various keywords. One of the keywords I used was 'hand hygiene.' The keyword directed me to multiple tabs containing the articles appropriate for the topic. Examples of these articles include the hand hygiene pdf paper from WHO, the five moments for the hand hygiene, facts about hand hygiene, hand hygiene practices from healthcare among others.

The next keyword I used was 'the hand hygiene education.' This keyword directed me to some articles containing information about the hand hygiene courses, Hand Hygiene in health care setting, tools for training and education, essentials for the hand hygiene in education programs among others.

The other significant keyword that I utilized in my literature review search is 'The hand hygiene as an issue in the healthcare setting.' The keyword directed me to various scholarly and non-scholarly articles about hand hygiene issues, problems related to failure to wash hands, the importance of maintaining hand hygiene among others. These articles and journals include WHO/evidence for hand hygiene guidelines, the global hand washing partnership, hand hygiene in healthcare, historical perspectives on hand hygiene among others.

The number and types of articles available for consideration

There are various types of articles that are available for consideration in my topic. One of the articles that were crucial in my literature review is "Hand Hygiene: Back to basics of the infection control," by Purva MacArthur. According to this article, hand hygiene is a crucial element when it comes to infection control activities. The author argues that there is an increasing burden resulting from healthcare-associated Infections. Various pathogen infections are drug resistant and which bring about illnesses. In fact, some of them are complex to treat. Simple hygiene measures like the washing of hands can easily reduce such cases.

Another relevant article that I found useful in the paper was "fact about Hand Hygiene," from the department of health, Government of Western Australia. The article highlights the meaning of hand hygiene and why it is essential. According to this article, hand hygiene refers to cleaning of one's hands through hand rub soap and water (Malihe et al., 2018). The spreading germs from an individual to another can lead to infections like flu and the common cold. This article educates people on when to clean their hands. These times include after visiting the toilet, blowing the nose, after smoking among others.

Also, the article on 'clean care is safer' by WHO was essential because it shows first-hand data on hand hygiene. According to the article, the problem of hand hygiene is vast. There are 1.4 million cases of sufferings from these unhygienic conditions (Salama et al., 2018). The hand hygiene, according to the research, has significant contributions to the health of the individual. It is a cheap way to prevent the spread of microbes which lead to healthcare-associated infections. Therefore, the paper recommends for improving hygiene through clean hands. The document also indicates various bacteria that spread from one person to another as a result of dirty hands. Some of these germs include Klebsiella, Enterobacter, Candida, Rotavirus among others. All those microbes are capable of spreading on the hands of healthcare staff.

'The Journal of infection and public health' is a quantitative article that is evidence-based. It shows the effect, of hand hygiene compliance on hospital-acquired infections. The case study for the paper is Kuwait teaching hospital. According to the article, hand washing is accepted widely as a mode of controlling diseases, especially in ICU. The poor compliance with hand washing guidelines results to nosocomial infections. The data used for this study involved 1508 events for a 7-month period. The research suggested doctors, nurses, and other health professionals.

According to Journal of caring sciences (2015), Hand hygiene is a meaningful way to curb any hospital infections. The article is a quantitative type of journal which investigates the nurses' knowledge regarding hand hygiene. It involved both descriptive and cross-sectional study in Tabriz University of medical sciences.150 nurses were surveyed under this investigation. The result showed that fair number of people is knowledgeable when it comes to hand hygiene. According to WHO report cited in this article, approximately 1,400,000 people suffer from hospital-acquired infections at any given time (Willmott et al., 2018). Most of these infections are transferred from one patient to the next due to hand hygiene issues. Therefore, individuals should maintain hand washing as a way of maintaining cleanliness and curb these infections.

a) Two research evidence and two non-research evidence used

The two research based articles used in this paper include 'The Journal of infection and public health' and Journal of caring sciences (2015).On the other hand, the two non-evidence based articles with valuable information about hand washing and hygiene include "fact about Hand Hygiene," from the department of health, Government of Western Australia and "Hand Hygiene: Back to basics of infection control."

Part E

E. Explain a recommended practice change (suggested length of 1-3 pages) that addresses the PICO question within the framework of the evidence collected and used in the attached "Evidence Matrix."

Various recommendations address the PICO questions from the evidence contained in the sources. According to the article titled "Hand hygiene practices among nursing students: the importance of improving current training programs" Syed Esam Mohammad Rakhee Verma2 and Mohammad Bilal Khan, hand hygiene reduces the probability of acquiring various infections. This research indicated that 60% of the respondents, who were females, received formal training on hand hygiene while the rest of them did Not.76 %, the majority number, agreed that unclean hands of healthcare workers resulted to harmful transmission germs between the patients(Shukla, Chavali and Menon, 2018). The hospital's air was the primary source of bacteria (70%).The research comes up with various recommen...