Hand Hygiene In Infection Prevention In The Post-Operative Patient. Research Proposal Examples

Introduction

The post-operative patient must be guided to observe hygiene of the highest standards in order to avoid the development of nosocomial infections or other infections after their discharge. Hand hygiene, in particular, is an important factor that can help in the avoidance of patient-acquired infections in post-operative patients. Poor hand hygiene could cause unnecessary infections that could hamper the healing process of the post-operative patient. Likewise, nurses must observe hand hygiene when dealing with post-operative patients. They must observe high hygienic standards in order to avoid the transmission of unnecessary infections to the post-operative patients.
Healthcare-associated- infections have been found to cause morbidity and mortality among hospitalized patients (Mathur, 2011). Post-operative patients have the highest risk of succumbing to such infections. In the USA alone, healthcare-associated- infections infect nearly two million people resulting in 80,000 deaths per year. Research has shown that the transmission of healthcare-associated-infections from healthcare professionals to patients occurs through contaminated hands (Mathur, 2011). In line with this, health care professionals are urged to wash their hands using detergent and water regularly. But the high levels of healthcare-associated-infections are indication of poor compliance. It is important to improve compliance among healthcare professionals in order to reduce hand-transmitted infections in post-operative patients.

Literature Review

Mathur (2011) contends that healthcare-associated- infections are attracting increasing attention from different circles such as insurers, government, and the public. Thus the concern is not due to the high mortality and morbidity or the associated cost of treatment, but because the infections are highly preventable. This problem is happening even in the wake of improved antimicrobials and diagnostic procedures.
However, there is new evidence that is suggesting that hand cleaning, the strict adherence to hand hygiene can help in the minimization of healthcare-associated- infections especially among post-operative patients. In line with this, the World Health Organization has started an initiated termed as ‘clean care is safer care.’ The program intends to provide developing countries with best practice policies that are geared towards improving hand hygiene in the clinical set-up. Mathur (2011) emphasize the need to establish gold standard procedures for implementing hand hygiene.
On the other hand, Allegranzi and Pittet (2010) indicate that hands of healthcare workers are the most common vehicles for transmitting pathogens within the healthcare setting. They also argue that hand hygiene is the simplest way of reducing antimicrobial resistance and preventing health care workers associated infections yet negligence is still highly prevalent.
In their research, these researchers evaluated factors that limit the observation of hand hygiene in the clinical setting. They found that the lack of gold standard hand hygiene protocol was the main cause of the problem. Hospitals that have well-defined hand hygiene policies have the least cases of healthcare-associated- infections particularly among post-operative patients. These researchers stress the point made by previous studies that a multimodal approach is needed. In other words, there is a need to establish uniform hand hygiene strategies, and hospitals must put in place resources and equipment needed to realize this goal (Allegranzi & Pittet, 2010).
On the other hand, Ellington et al. (2014) discuss the best available strategies for improving hand hygiene. First, they highlight different strategies for measuring the extent of hand hygiene in the clinical setting. Secondly, they highlight different evidence-based strategies for improving hand hygiene. Ellington et al. (2014) contend that the measurement of hand hygiene can be attained through direct observation or technology-assisted observation.
In line with this, these authors note that it is important first to measure the level of hand hygiene prior to initiating changes. Again, Ellington et al. (2014) emphasize the significance of establishing well-defined policies or guidelines for maintaining hand hygiene in a clinical setting. These guidelines should then be communicated to the entire nursing staff. Furthermore, Ellington et al. (2014) suggest the establishment of a department to manage the implementation of hand hygiene. Moreover, there should be protocols for assessing the progress of the implemented policies, as well as an opportunity to provide alternatives.

Levels of Evidence

The three articles are evidence-based, and all emphasize the significance of establishing gold standard policies for maintaining hand hygiene in the clinical setting. In addition, they call for the establishment of a managerial team that would oversee the implementation of the hand hygiene procedures. It is also important to invest in resources and equipment that would promote hand hygiene in the clinical setting. Post-operative patients are at the greatest risk of acquiring healthcare-associated- infections, therefore, hand hygiene is the only solution. The proposed plan is in line with the action research plan.

Problem posing Planning Observing Reflecting.

In order to implement this solution in practice, a number of steps ought to be taken. First, as documented by the above articles, it will be essential to adopt gold standard policies for maintaining hand hygiene in the clinical setting. Secondly, there is a need to establish a managerial team that would oversee the implementation of the hand hygiene procedures. Thirdly, it is important to invest in resources and equipment that would promote hand hygiene in the clinical setting. Fourthly, there should be checks are balances that will help in assessing the progress of the implementation. In essence, the evaluation scheme ought to check regularly the progress of the implemented policy, as well as predict solutions to challenges experienced along the way.

References

Allegranzi, B., and Pittet, D. (2010). Role of hand hygiene in healthcare-associated infection prevention. The Journal of Hospital Infection, 73(4), 305–315. Retrieved from http://www.journalofhospitalinfection.com/article/S0195-6701%2809%2900186- 8/fulltext
Ellington, K., Ailleo, A., Kusek, L., Maragakis, L. et al. (2014). Strategies to Prevent Healthcare- Associated Infections through Hand Hygiene. The Journal of Infection Control and Hospital Epidemiology, 35(8), 1-10. Retrieved from http://www.jstor.org/stable/10.1086/677145
Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. Indian Journal of Medical Research. 134(5): 611–620. doi:  10.4103/0971-5916.90985. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/