Hand Hygiene

Hand Hygiene

Hand Hygiene (HH) is one of the most effective ways of reducing hospital transited infections (HTIs) in the healthcare setting. However, most healthcare professionals fail to comply with the international standard guidelines for hand hygiene negatively affecting the health and safety of patients. Poor HH of health workers has led to increased mortality rates among patients admitted in hospitals. More awareness needs to be created among the healthcare workers about the importance of HH to reduce the increased mortality rate. Healthcare agencies need to take the responsibility of ensuring their staffs are fully aware and adhere to World health Organization (WHO) guidelines for hand hygiene (Sadule-Rios &Aguilera, 2017).

PICOT Statement

For healthcare workers in Hospital does alcohol based solutions compared to hand washing protocol prevent hospital acquired infections during the period patients stay in healthcare facilities.

Evidence based solution

Alcohol based solutions have been used widely across the world. Studies show that this approach to HH irritates hands less often, removes germs effectively and requires less time as compared to hand washing. Alcohol based solutions are also more accessible as compared to sinks. This approach to HH is more effective when the hands are not soiled. However, in situations where dirt can be seen on the hands, health workers should clean their hands using water. Alcohol-based solutions have good microbial activity against various bacteria and viruses. Multiple studies show that alcohol based solutions are more effective in the healthcare setting as compared to hand washing protocol (Lehotsky et al., 2017).

Nursing Intervention

Patients who have been admitted in the hospitals interact with nurses more often than any other healthcare professional. For this reason, nurses must take precautionary measure to ensure patient security and overall wellbeing. Nurse practitioners should use alcohol based solutions before and after interacting with patients. This will reduce the spread of infections in the healthcares setting. Nurses should also follow the WHO guidelines which require them to wear protective gear before interacting with patients. This will prevent them from acquiring infections from one patient and transmitting it to other patients within the hospital (Garus-Pakowska, Sobala & Szatko, 2013).

Patient Care

One of the most important goals for healthcare facilities is to provide quality services to patients. Without proper HH this goal cannot be achieved. Hospitals should create proper HH guidelines to be followed by all patients admitted in their facility. Healthcare providers should also ensure that their patients are fully aware of these guidelines and ensure they are followed to the latter. Enough alcohol based solutions should be provided to ensure patients adhere to the guidelines (Deochand & Deochand, 2016). The healthcare workers should also ensure that visitors clean their hands before visiting the patients and after leaving wards. This ensures visitors do not bring infections to the patients.


Health care agency

One of the main responsibilities of the healthcare agency is to provide enough alcohol based solutions to both patients and healthcare professionals. Without enough resources they will be unable to follow the WHO HH guidelines. The healthcare agency should also ensure it has enough sinks with running water to ensure that patients and healthcare professionals can clean their hand when they have less supply of alcohol based solutions. They should also ensure they create awareness among their healthcare professionals about the importance of HH. Occasional audits should also be conducted to ensure nurses comply with the set HH guidelines (Chatfield et al., 2016).

Nursing Practice

Most of the hospital acquired infections can be prevented by combining the alcohol based solutions and hand washing protocol. These techniques can complement one another increasing patient safety and care in hospitals. Nurses should comply with the WHO guidelines to reduce spread of infections in the healthcare setting (McLawsa et al., 2014). The implementation of standard HH guidelines will ensure a safe and secure healthcare environment. This will also improve patient outcomes and their overall well being. This can go a long way in reducing hospital stay as a result of hospital-acquired infections. All hospital stakeholders need to take the necessary precautions to prevent the spread of these infections.


Chatfield, S. L., Nolan, R., Crawford, H.  and Hallam, J. S., (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE Open Medicine Volume 4: 1 –9

Deochand, N., & Deochand, M. E. (2016). Brief Report on Hand-Hygiene Monitoring Systems: A Pilot Study of a Computer-Assisted Image Analysis Technique. Journal of environmental health78(10). Journal of Hospital infection 97 (2017) 26-29

Garus-Pakowska, A., Sobala, W., Szatko. F. (2013).  Observance of hand washing procedures performed by the medical personnel before patient contact part 1.International journal of occupational medicine and environmental health 2013

Lehotsky, A., Szilagyi, L. , Szeremy, P., Weber, G., Haidegger, T. (2017). Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure.

McLawsa, M. L., Farahangizb, S., Palenikc, C. Askariand, M., (2014). Iranian healthcare workers’ perspective on hand hygiene: A qualitative study. Journal of Infection and Public Health (2015) 8, 72—79

Sadule-Rios, N., Aguilera, G. (2017). Nurses’ perception of reasons for persistent low rates in hand hygiene compliance. Intensive and Critical Care Nursing 42 (2017) 17-21

Most hospital acquired infections are as a result of human actions. Hand hygiene (HH) is a great way to prevent the spread of germs that cause these infections. However, studies show that nurse wash their hand less than they should contributing to the spread of these infections. This also puts patients at the risk of being infected during their stay in healthcare facilities. HH can prevent the spread of these infections and reduce hospital stay for patients. This paper aims to review various studies that are related to this topic and determine how they support the PICOT statement.

PICOT Statement

For healthcare workers in Hospital does alcohol based solutions compared to hand washing protocol prevent hospital acquired infections during the period patients stay in healthcare facilities.

Comparison of research Questions

A study conducted in 2015 aimed to establish whether technology can be used to do away with health acquired infections in hospitals (Al Salman et al., 2015). Another study conducted in 2017 aimed to establish whether HH is enough for the prevention of cross-contamination on hospital wards (Hor et al., 2017). A thirds study done in 2016 focused on assessing the knowledge and attitude of nursing staff and residents towards hand hygiene in relation to reducing hospital-acquired infections (Maheshwari, 2014). The fourth study reviewed in this paper was conducted in 2015 and aimed to assess the attitude, knowledge to HH guidelines of nursing students and final year medical students towards hand hygiene in relation to reducing hospital-acquired infections (Ariyaratne et al., 2015).

Another study conducted in 2019 aimed to explore the attitudes cleaning staff in hospitals as HH (Sendall, McCosker & Halton, 2019). In 2016, another research was conducted aiming to establish whether Hand-Hygiene Monitoring Systems are effective at reducing hospital acquired infections (Deochand & Deochand, 2016). Another study also conducted in the same year aimed to capture the experiences of HH among acute care nurses. This involved interviewing nurses to give their perceptions about HH (Chatfield et al., 2016). Finally, a study conducted in 2016 aimed to identify the knowledge of HH in the fight against HAI present in teaching hospitals affiliated to Zabol University (Sarani et al., 2016). All these research questions aimed to determine the effectiveness of HH in healthcare facilities.

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