Question

Topic:How does handwashing prevent intensive care unit patients in the hospital from nosocomial infection compare to usage of hand sanitizer to reduce the risk of infection in the first two weeks?

DIRECTION: Please review my paper

Course project

In recent years, attention to health care associated infections (HAIs) formerly referred to as nosocomial infections. The impact of infectious disease changes through time as microorganisms mutate, as human behavior patterns shift, or as therapeutic options change. HAND HYGIENE: The most frequent cause of infection outbreaks in health care institutions is transmission by the hands of healthcare workers. Hands should be washed or decontaminated frequently during patient care. When hands are visibly dirty or contaminated with biologic material from patient care, hands should be washed with soap and water. In this paper we will emphasize the effectiveness of hands hygiene compare to hands sanitizer.

PICOT

In intensive care units and other locations in which virulent or resistant organisms are likely to be present antimicrobial agents such as chlorhexidine gluconate, iodophors, chloroxylenol and triclosan may be used. Effective hand washing requires at least 15 seconds of vigorous scrubbing, with special attention to the area around nail beds and between fingers, where there is a high bacterial load. Hands should be thoroughly rinsed after washing. Because they are formulated with emollients, they are usually better tolerated than other agents, and because they can be used without sinks and towels. Hand washing or disinfection reduces the bacterial load and decreases the risk of transfer to other patients.

Hands Hygiene and hand sanitizer

When hands are not visibly soiled, health care providers are strongly encouraged to use alcohol-based waterless antiseptic agents for routine hand decontamination. These solutions are superior to soap or antimicrobial handwashing agents in their speed of action and effectiveness against microorganisms. Reduction in the infection rates and microbial counts on health care providers.Also, improvements in skin conditions of health care providers and reduction in infection rates. Other practices such as frequency and quality of hand hygiene reduces the risk of cross-contamination.

Integration of evidence

Direct observation of hand hygiene by health care providers is considered as the " golden standard" of measurement methods. Observation helps to allow which hand hygiene products are used, the thoroughness of cleansing, the tools and techniques used for drying, the use of gloves,and whether the staff are performing hand hygiene whenever there is an opportunity to do so. This method helps to give a feedback when improvement is needed. MEASURING PRODUCT USE: Measuring the amount of soap, alcohol-based hand rub and paper towels that health care workers used is an indirect way of estimating staff adherence to hand hygiene guidelines.

Implementation of methods

Effective hand washing requires at least 15 seconds of vigorous scrubbing, with special attention to the area around nail beds and between fingers, where there is a high bacterial load. Hands should be thoroughly rinsed after washing. If hands are not visibly soiled, health care providers are strongly encouraged to use alcohol-based waterless antiseptic agents for routine hand decontamination.

Conclusion

Hospital acquired infections (HAIs) is a major safety concern for both health care providers and the patients. Considering morbidity, mortality, increased length of stay and the cost, efforts should be made to make the hospitals as safe as possible by preventing such infections.The best and most effective way to prevent is perfoming hands hygiene to avoid spreading diseases such as C.diff which is resistant to alcohol base hand sanitizers.

Answer 1

Comparison of Handwash Vs Hand rub:

Introduction:

Hand hygiene is the primary thing in the reduction of Hospital Acquired Infections. The route of transmission of microorganisms is through the Healthcare workers Hands. It is the Universal standard precaution in the prevention of CAUTI, VAP, Vascular catheter, and SSI. The principles of the hand hygiene are the use of correct technique and at the correct time. The five moments of hand hygiene are

• Before touching the patient
• Before performing any procedure
• After contact with any body fluids
• After touching the patient
• After touching the patient surroundings.

The effectiveness of the Hand hygiene:

Hand hygiene is performed either by using soap and water or alcohol-based hand rub. Washing with soap and water requires 40-60 seconds of rubbing and hand rub requires 20-30 seconds of rubbing and both used to cover all surfaces of the hands. When the hand is not soiled, the hand rub is used at the point of care.

The conclusion of the Clinical trials:

The comparative study of hand wash and hand rub was performed in the ICU unit among 34 nurses. the findings showed that the E.coli, Klebsiella, Gram-negative bacilli, streptococci, staphylococci are present on the 92.2% of the sample hands. After hand washing with soap and water, about 50% of samples show the reduction in the bacterial flora whereas the alcoholic hand rub shows 95% effectiveness.

Another study was conducted in NICU unit concluded, there is no significant changes were found between the hand washing and hand rub in the prevention of HAI in neonates during the period of two years. The Center for Disease Control and Prevention also recommends the alcohol-based hand rub which improves the skin condition, less time consuming and improve the quality of hand hygiene.

Conclusion:

Comparing to other antiseptic solutions, alcohol-based hand rub is more effective against bacterial spores. But in case of Hand decontamination with noroviruses such as Clostridium difficile hand washing with soap and water is more effective. Additionally, use of other precautionary measures is also important. Caution and health education should be made among health workers when to use hand rub and to do hand washing in a specific situation rather than discouraging the use of hand rub. Frequent use of hand rub is more effective for hand hygiene improvement and safety for both patients and health workers.