Over the years, hand hygiene has been advocated for but, compliance is still low among the health workers. However, hand hygiene has been practiced more as the years go by and as people learn about the importance of hand hygiene. Although hand hygiene is considerably simple, it requires self discipline from the health workers to comply with the policies.
Compliance With Hand Hygiene Policies
Compliance hand hygiene policies health care facility Richmond hospital Texas
Compliance with hand hygiene policies in Richmond hospital, Texas
Hand hygiene policies are a plan of action adopted by health care providers that aim at preventing the transmission of infections or microorganisms from a patient to patient or from inanimate objects and surfaces to a patient through the hands of a healthcare provider or any other person dealing with a patient. They are specific hand hygiene practices carried out to reduce the risk of acquiring a hospital acquired infection, also known as nosocomial infections. This protects the patient, the hospital staff and even visitors.
Hand hygiene policies
The policies indicate when the staff must perform the hand hygiene activities; it also states the types of agents that should be used to achieve hand hygiene and any other measures. The policy indicates that:
Hand hygiene should be practiced before and after handling a patient even if gloves were worn. This involves washing of hands with soap, rinsing then drying off the hands. Application of alcohol hand rub is also acceptable. This is also expected to happen after visiting the rest room and before leaving work.
Antiseptic hand washing products shall be used or alcohol hands rub. The alcohol hand rub may be used in place an antiseptic soap hand wash. In case the hands are grossly contaminated, they should be washed with liquid soap before disinfecting with alcohol hand rub.
Use of gloves is mandatory when exposure to blood, serum or other body fluids is likely.
When handling a patient, one is required to start cleaning from the cleanest area (e.g. Mouth care and proceed to the dirtiest site (e.g. handling urinal catheter). If need be that one need to handle a clean site having dealt with a dirty site, the hands should be washed between site.
In addition to this, healthcare workers who handle patients directly must maintain their fingernails and ensure that the tip of the nail does not extend past the edges of their fingers. Artificial nails or acrylic overlays are not allowed. The nail polish must not be chipped or cracked Centers for Disease Control and Prevention, 2002()
Compliance to the hand hygiene policies
Studies conducted by CDC (Centers for Disease Control and Prevention) in 1980-2001show that compliance to the recommended hand hygiene procedure was poor among the health care workers. The studies showed that compliance was at an average low of 40% Boyce JM, 2002()
This led to the government making hand washing policy mandatory making it a national patient-safety goal. This required health facilities to establish programs that monitored compliance and also a continuous compliance improvement. Only then could such a facility be accredited.
The increased use of alcohol hand sanitizers in the facilities has made hand hygiene practices more convenient and also less time consuming. This is because they eliminate the need for hand washing sinks. They are convenient in the fact that the sanitizers are small and are usually supplied at accessible places along different areas of patient care. Some can be carried around in the pocket or can even be worn. An observational study carried out showed that the availability of hand sanitizers in an ICU "resulted in a sustained increase in hand antisepsis rates among health care workers."Earl ML, 2001()
Another study compared the effects of alcohol hand sanitizer to that of hand washing using an un-medicated soap showed that the hand sanitizer was less damaging to the health workers skin.
Importance of compliance
Hospital acquired infections are preventable. This calls for implementation of risk reduction interventions and these include hand hygiene. Studies show that up to 20% of nosocomial infections can be prevented by merely observing hand hygiene. It is, therefore, important to observe hand hygiene. Preventing hospital acquired infections eliminates certain disadvantages that are associated with nosocomial infections such as illnesses, added costs and even death Hsin Chi, 2009()
Factors affecting hand hygiene compliance
1. Unavailability of hand washing basins or sinks.
2. Inadequate knowledge of the policy and its guidelines and the problems associated with hand hygiene.
3. Hypersensitivity or allergic reaction to the hand hygiene product
4. Lack of adequate time to perform hand hygiene practices. This can be observed if the patients are many and there is low staffing.
5. Individual habits or preference
Recommendations
Healthcare facilities should establish continuous monitoring programs to ensure that everyone adheres to the hand hygiene policies. Hospital staff should be educated on the importance of complying to hand hygiene policies. The hospital administration should ensure that cleaning areas and hand sanitizing products are readily available for the staff to use and also hold staff accountable. The hand sanitizers can be placed in many areas where patient care is provided so as to increase hand hygiene opportunities.
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