Hand Hygiene and Alcohol

Practicum Project According to Ho et al. (2015), statistics indicate that approximately 20% to 40% of health care associated infections have been linked to cross-infection through the hands of health care workers. Efficacious hand hygiene is imperative to prevent communication of healthcare associated pathogens. A great deal of hand hygiene programs in healthcare settings lay emphasis on compliance of healthcare personnel, for the reason that transitory contamination of their hands is deemed to be the key basis for transmission of pathogens (Kundrapu et al., 2014).

The use of alcohol-founded hand sanitizers in health units has become prevalent since their recommendation by the Centers for Disease Control and Prevention (CDC) during 2002. This was acclaimed due to patient interaction especially in case hands are soiled, physically. However, alcohol-based hand sanitizers are not efficacious against some classifications of pathogens (Carter, 2013).

The problem identified is in healthcare settings; are the use of alcohol base hand rubs more effective or less effective in reducing hospital rate infection statistics (HRIS) in comparison to water and soap techniques? Problem My mentored practicum experience took place in an Acute Rehabilitation/ Brain Center. Nursing care can be undertaken via a mixture of organizational approaches. The model of nursing care utilized differs largely from one healthcare facility to another and from one set of patient situations to another.

The model of care delivery applied in my practicum experience is progressive patient care. This is a system of nursing care in which the patients are set in units based on their necessities for healthcare as ascertained by magnitude of illness (Current Nursing, 2012). Our unit was made up of 10 nurse assistants and 8 registered nurses. The main way in which my nurse manager proposes to solve this problem is the use of alcohol-based hand sanitizers five times before washing hands with soap and water.

With the manager employing a dictatorial style of leadership, the decision-making process employed is one that fails to take into consideration the thoughts and ideas of external sources or internal sources such as employees. This particular problem has an adverse impact on patient outcome. Taking into account the fact that alcohol-based hand sanitizers are not fully effective in eradicating bacteria, particularly C. difficile bacteria, this solution leads to poor patient health care (Carter, 2013). In the end, this can give rise to patient dissatisfaction.

In addition, it can lead to lack of employee motivation as they have no sense of input in activity and their opinions are not taken into account. Intervention I believe that this problem could be resolved in a different way from the manager's proposal. In particular, my proposal entails employing soap and water in washing hands. Moreover, if there is a low level of hospital rate infection statistics for a period of 6 months, the personnel ought to receive financial bonuses and also have a written note in their personal file.

Kundrapu et al. (2014) ascertained that the hand of patients with Clostridium difficile infection (CDI) and asymptomatic carriers were repeatedly contaminated with C. difficile bacteria. This sort of contamination could prospectively lead to transmission or recurrence of CDI when bacteria on hands are consumed. The research indicated that soap and water washing was efficacious for diminishing the rate of recurrence of constructive cultures and the problem of bacteria on hands, while alcohol hand rub was not.

Results of the study recommend that patient hand washing could be a beneficial and simple way to execute aide to standard control measures for C. Difficile. Carter (2013) assesses the ideal balance between hand washing and hand sanitizers. The articles consider the question whether over dependency on alcohol-based hand sanitizers has played a part in causing disease outbreaks or generating more infectious strains of pathogens.

The author obtains insight from experts such as Aron Hall, who happens to be an epidemiologist and an expert at the CDC's Viral Diseases Division, along with Clifford Mcdonald, who is an authority of C. difficile as well as high-ranking adviser intended for science and integrity at the CDC's Health Quality Promotion Division. It is noted that overreliance was not a case as noroviruses mutate quite repeatedly. Both experts agree that there is no evidence that alcohol-based hand sanitizers played a part in strain or outbreaks selection.

The recommendation is going against additional modifications in CDC guiding principles so that the substantial advancement in ABHS use, leading to decreasing health-linked infections, will not be misplaced. In overall, the proper equilibrium for hygiene of hand encompasses increased devotion to appropriate hygiene of hands via education and constantly prompting staff to at least scrub all hand surfaces for at least forty to sixty seconds with water and soap or twenty to thirty seconds with 3 to 5 mL involving alcohol. The research study by Edmonds et al.

(2013) sought to determine whether surrogate organisms are able to envisage activity against C. Difficile bacteria and made the comparison of the effectiveness of hygiene processes against C. difficile. The outcomes of the study delineate that C. difficile bacteria were much harder to remove through hand washing in comparison to bacteria of surrogate species. These outcomes are in line with preceding research studies and point out that surrogate organisms ought not to be employed to predict effectiveness of hand hygiene against C. difficile bacteria.

Moreover, the results of the study show that prevailing hand hygiene interventions have restricted effectiveness against C. difficile spores. As a result, healthcare workers ought to continue adhering to the recommendations for hand washing with soap and water and lay emphasis on contact safety measures for providing healthcare to patients with CDI. According to Ho et al. (2015), the use of alcohol hand rub is acknowledged as the gold standard for hand hygiene of non-soiled hands and is deemed to decrease the time needed for hand hygiene.

On one hand, recommendation from the World Health Organization (WHO) is to employ alcohol hand rub adhering to the similar 7-step procedure as for handwashing with antimicrobial soap and water. On the other hand, the recommendation from the Centers for Disease Control and Prevention (CDC) is the application of alcohol for covering all surfaces of both hands and fingers to the point when hands are dry.

The authors attempt to assess the efficacy of 3 hand hygiene procedures in decreasing hand carriage of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) amongst health care workers. The research study demonstrates that use of alcohol hand rub, either covering all hand surfaces in no precise directive or by means of the 7-step procedure, and chlorhexidine handwashing, were similarly efficacious for the elimination of hand carriage of MRSA and MSSA. According to Tuladhar et al.

(2015), human norovirus is the principal origin of acute gastroenteritis, which affects individuals of all age brackets. The spread of the virus takes place either directly through person-to-person contact or indirectly through soiled food, water, and environmental fomites. A great deal of norovirus epidemics are linked to person-to- person spread and hands are considered to be a primary means for spreading viruses, directly or indirectly. In addition, human norovirus, and other pathogenic infections can continue being communicable on human hands for hours. The research study by Tuladhar et al.

(2015) tested the effectiveness of alcohol hand antiseptic against human enteric and respiratory infections. It also compared the effectiveness of an alcohol-based hand antiseptic and handwashing with soap and water against norovirus. Therefore, the authors concluded that washing hands with soap and water is more effective compared to using alcohol-based hand antiseptics in eradicating noroviruses from hands. For this reason, it is the favored intervention method to preclude communication through hands in healthcare environments and food preparation amenities. Other facilities deal with this problem differently.

A different approach utilized is that of smearing alcohol to cover all surfaces of both hands and fingers until the hands are dry. I believe the good solution to this problem is utilizing the 7-step technique as for handwashing with antimicrobial soap and water. In addition, I also consider staff education and training to be a longstanding solution to this particular problem.

Personnel enlightenment enables them to have a better understanding as to why using soap and water in hand washing is the most efficacious approach for eradicating bacteria and precluding hospital infections (Ho et al., 2015). Comparison In the contemporary, the manner in which the issue, whether alcohol-based hand rub is more effective or less effective in reducing HRIS than soap and water techniques, is taken care of subsequent to using alcohol-based hand sanitizers five times, is washing hands with soap and water. However, this particular approach is ineffective.

This is due to increase in hospital rate infection statistics. There is a great need for more education of employees. It is imperative to note that personnel are adherent to the commands and directions given. A great deal of employees are uninformed that alcohol is ineffectual in killing pathogens, and this suggests the great need for education of employees in dealing with infections and the significance of hand washing (Kundrapu et al., 2014). The manager within the unit employs a dictatorial style of leadership.

In essence, being an autocratic leader, the manager tells the employees what she wants them to do. In a dictatorial leadership style, the individual giving the orders has complete authority and control over decision-making. By virtue of their position and job duties, they not only control the determinations of the team, but also constantly observe them under close examination to ensure they accomplish their duties. The decision-making process encompasses handing down instructions to the members within the unit devoid of any discussion or vote.

The leader does not enquire for any recommendations or thoughts from external sources and chooses from his or her own inherent information and discernment of the state of affairs (Leadership Management Development Center, 1997). For instance, in this case, the manager of the unit hands out instructions for the employees to wash their hands using soap and water subsequent to using alcohol-based hand sanitizers five times, without taking into account the thoughts, perspectives and experiences of personnel working under her. This problem does have an impact on patient outcome.

In particular, owing to the decision made and the issue at hand, staff within the unit still walk around with dirty gloves outside patients' room. In turn, this has had an adverse impact on patient case as it recently gave rise to two patients developing Clostridium difficile infection (CDI). As initially pointed out, alcohol hand rub is not efficacious in diminishing the rate of recurrence of constructive cultures and the problem of bacteria on hands (Kundrapu et al., 2014; Tuladhar et al., 2015).

Therefore, in general, this gives rise to lack of patient satisfaction, which is the core of the healthcare unit. In addition, this has an impact on staff. One of the immediate effects is that personnel are obligated to adhere to the autocratic decisions made by the manager devoid of any of their input taken into consideration for improving team effort. In this case, regardless of whether the staff consider the need to undertake hand washing with soap.