Hand Hygiene in Healthcare Settings

Junior (College 3rd year) ・Healthcare&Medicine ・APA ・7 Sources

The research study is about how the hand hygiene can prevent the transmission of influenza among nurses in the healthcare facilities. In that case, the primary method for data collection involved the use of questionnaires as different healthcare professionals from various healthcare facilities were interviewed.  Also, with the advancement of the healthcare sectors nurses and patients are still vulnerable transmission of diseases such as influenza. This is a disease that can be transmitted in households and community settings, including hospitals facilities. Recently, the transmission has been common among nurses and between nurses and patients also. Therefore, it was imperative to carry out research that will result in suggestions and recommendations for future improvement.

Keywords: hand hygiene, healthcare settings, healthcare professionals, influenza, medical practice, nurses


Influenza is a community base infection that can be transmitted in community and households settings.  For instance, 20% of the US residents acquire influenza every year, and many have learned to seek medical healthcare from ambulatory healthcare settings such as urgent-care clinics and pediatric offices (Allegranzi, 2012).  In addition to the 20%, on average, more than 200000 people are hospitalized yearly with cases of influenza-related complications. Healthcare issues that are associated with the influenza infections can also occur in any healthcare setting (Bresee, 2009). This is common with the circulation of influenza in a given community. Therefore, it is imperative to outline and discuss how hand hygiene can reduce or prevent influenza transmission among nurses working in healthcare facilities.

Literature Review

Worldwide provision of healthcare is associated different range of safety problems. Even with the advancement in the sector of healthcare, patients and nurses are still vulnerable to any unintentional harm that can be found in hospitals (Jones, 2011). Healthcare association infection, which is also known as the hospital-acquired infection has become the most significant and discussed issue in the healthcare delivery of every hospital. In that case, hand hygiene has been considered a key factor that can help with the reduction of hospitals acquired infections. Furthermore, the battle against healthcare-associated infection started when there was the frequent occurrence of puerperal fever in the maternity ward. This was common with women who were being attended to by physicians and medical students, especially during labor. It was noted that most of the medical students and physicians were contaminating their hands while performing medical activities such as autopsies and at the same time examining women who were in labor without washing their hands.

In spite of the increasing problems, which comes with healthcare-associated infection, the rate at which many healthcare settings practice hand hygiene is still unacceptably low.  Compliance rate in many countries does not exceed 50%.  For example, compliance rate in the UK is 30%, Switzerland is 42%, and the United States of America is 50% (Van-Tam, 2013).  For that reason, poor compliance in many countries has resulted in increased mortality and morbidity rate. Every year 88 to 100 thousands deaths are attributed to healthcare-associated infection (Van-Tam, 2010). Furthermore, the healthcare-associated infection has affected more than 10% hospitalized patients ad this has been presenting major challenges to many healthcare facilities. As a result, annual medical expenditure has increased to $4.5 billion giving the United States case as an example (Petersen, 2006). Similarly, in Canada, more than eight thousands of patient die annually because of healthcare-associated infection. The government of Canada has been spending more than $100 million annually in treating patients with healthcare-associated infection.

The practice of hand hygiene among healthcare workers has proven to be the most clinical and cost-effective method of preventing healthcare associated infections. Therefore, is essential that the method is included in healthcare delivery processes to avoid any case of possible infection and consequent complications. Furthermore, hand hygiene is supported by the Clean Care is Safe Care program, which was introduced by the World Health Organization in 2005 (Von, 20150. The program offers several guidelines regarding the training on hand hygiene, performance, and observation in any healthcare setting.

Aims and Objectives

The primary objective of the research study is to investigate on how hand hygiene can reduce influenza transmission among nurses working in healthcare facilities. With this specific objective, it will be essential to look into the factors affecting hand hygiene and at the same time identifying the problems that can be used in improving hand hygiene as one of the preventive measures for healthcare association infection.

Materials and Method

The method for data collection during the research study was based on the primary study in which data were collected using questionnaires. The questionnaire forms were structured in the manner that between 30 to 40 participants were allowed to participate in the process of data collection. Interviewing was also an alternative method for data collection. Interview processes were carried out in various hospital facilities in the United States of America and Canada by extension. Research on various materials for literature review was also based on the effectiveness of the technique of healthcare hygiene, policies for controlling infection, and hand hygiene in healthcare. This was achieved by conducting the systematic review of qualitative literature materials.

Results and Observations

According to the findings regarding the research on hand hygiene in healthcare, the hands of nurses are usually in contact with the patients. The hands are also frequently contaminated because of palpation, auscultation, and continues touch of contaminated devices, materials, and working surfaces as well. In that case, hand hygiene has proven to be a cheap, effective, and essential method for preventing cross infection. Based on the observations made during the data collection and interviewing processes, hand hygiene is the method, which is designed to save lives and at the same time provide a safe environment for treating all patients regardless of the type of setting.

Also, it was observed that nurses are usually present in hospital facilities 24/7. Therefore, it is essential that they comply with the policy that comes with hand hygiene, with the aim of maintaining patient safety.  After all, every nurse must safeguard and advocate for the patient safety. Nurses are ethically and professionally accountable for the actions they take while on duty. For that reason, the code of conduct requires nurses to provide standard healthcare practice at all time. However, some nurses have presented low compliance. This is a problem, which they must deal with for quality delivery of services. From the research study, it was observed that most of the nurses usually fail to practice hand hygiene because of the pressure that comes with a busy schedule. Majority of them feels like the process of carrying out hand hygiene take up their precious time. They prefer using gloves instead of washing hands and forget to use the same gloves more than two times.

Moreover, most of the findings were themed to the fact that healthcare workers are the contributing factor that comes with the compliance to the guidelines of hand hygiene compliance. However, some of the contributing factors were hypothesized based on theoretical background. Also, the utilization of the qualitative literature made it possible in understanding the inductive approach and affecting the phenomenon of hand hygiene. In that case, it was a clear observation that two concepts have influenced the compliance of nurses and healthcare workers when it comes to hand hygiene guidelines. These include the perception of the working environment and motivational factors, which are also grounded by behaviorism.


According to the results, findings, and observations made during the research study, healthcare professionals should perform hand hygiene on a frequent basis. This should be practiced before and after have a contact with patient and materials, which are considered to be potentially infectious. Also, it is imperative that healthcare professionals adopt the habit of hand hygiene when putting and removing protective gears such as gloves. Hand hygiene is a simple process involving the washing of hands using alcohol-based hand rubs and soap combined with water. Suppose the hands are visibly soiled it is recommended that the cleaning process is performed using soap and water and not hand rubs involving the use of alcohol.  Furthermore, the healthcare facilities must ensure that supplies that will promote hand hygiene are readily available.

During the medical practice, it is essential for nurses to wear gloves while making contact with infectious materials. Afterward, remove the gloves as described in the guidelines for hand hygiene. The same gloves should not be used more than one time while performing any medical activity. Also, the gloves should not be washed for future reuse. This does not give logic regarding the guidelines for hand hygiene. Moreover, nurses should adopt the culture of putting on gowns for any medical activity that can bring contact with body fluids, blood, excretions, or excretions. The gown should be removed and then perform the hand hygiene before vacating the environment of the patient. The same gown should not be wear for more than once.

Suggestion and Recommendation

According to the research findings, the following suggestions and recommendation are viable to the study:

Ø An improved practice of hand hygiene requires a multifaceted approach including both facility factors and individuals.
Ø Hospital administrations and staff members for infection control should be active in improving how hand hygiene is practiced in healthcare facilities.
Ø Patients should also be empowered in monitoring those who are employed to offer medical services to their medical problems.
Ø The rate of compliance with the guidelines for hand hygiene has remained a collective challenge that will require the stakeholders involved to come up with a standard and consistent approach.
Ø Theoretical methods should also be used intentionally because they are useful in explaining the complexity that comes with hand hygiene.


Allegranzi, B., & Pittet, D. (January 01, 2012). Hand Hygiene. 418-444.

Bresee, J., Centers for Disease Control and Prevention (U.S.), & National Center for Immunization and Respiratory Diseases (U.S.). (2009). Influenza round table.   Atlanta, GA: Centers for Disease Control and Prevention.

Jones, R. M. (August 01, 2011). Critical Review and Uncertainty Analysis of Factors Influencing Influenza Transmission. Risk Analysis, 31, 8, 1226-124

Petersen, E. A., & Medfilms, Inc. (2006). Influenza. Tucson, Ariz: Medfilms Inc.

Van-Tam, J., Sellwood, C., & C.A.B. International. (2013). Pandemic influenza. Wallingford, Oxfordshire: CABI.

Van-Tam, J., Sellwood, C., & C.A.B. International. (2010). Introduction to pandemic influenza. Wallingford, UK: CAB International.

Von, H. P. (January 01, 2015). Infection and Immune System.

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