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Awareness Of Good Hand Hygiene Practices

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Question:

Discuss about the Newly Joined Health Care Workers to Promote Awareness of Good Hand Hygiene Practices.
 
 

Answer:

Introduction

Health care-associated infection (HCAI) has been persisting as a major issue in the last few years as almost every healthcare setting is facing negative health outcomes like mortality, morbidity and increased cost of healthcare. Handwashing has been indicated as the most effective way to prevent the rising incidences of health care- associated infections. However, research has indicated that healthcare workers are not adhering to the hand washing techniques to the extent desired (Zingg et al., 2015). The present writing focuses on the reasons why there is a lesser emphasis on hand hygiene in the healthcare setting, therefore leading to unsafe practice. The next section of the paper would outline the ways in which a new employee can help in the reduction of the undesirable outcomes. The focus of the paper would be on National Safety and Quality Health Service Standards (NSHQS) 3.1.

Why there is lesser emphasis on hand hygiene in the healthcare setting, therefore leading to unsafe practice

Healthcare worker compliance with hand washing guidelines has been known to be a cornerstone of ideal infection control practices. However, a rich pool of literature has indicated that healthcare workers, especially those who have recently joined any health care setting, do not strictly follow the hand hygiene protocols (Dai et al., 2015). The reason for healthcare workers to have this negative approach towards hand washing is multi-faceted. Firstly, a worker going for a hand wash might not be getting a sanitizer os soap at their disposal. Some workers have an attitude that washing hands often would lead to drying out of their skin. For others, they might need more convincing that had washing is essential. Lastly, hand hygiene might be at times overlooked due to the fact that the other responsibilities and duties the workers have demanded more attention in a healthcare setting that is often chaotic.  A number of challenging aspects of the regular duties of a healthcare worker compel them to neglect hand washing procedure at a regular interval. Many healthcare settings lack leadership, and such poor leadership leads to a poor overseeing of proper adherence to set guidelines for the workers. The intension of improving knowledge and compliance to hand washing have been incorporated in many settings against this background  (Pan et al., 2013).

How new employee can help in reducing the outcome

The National Safety and Quality Health Service Standards (NSHQS) are the set of guidelines for achieving better healthcare results. NHSQ Standard 3 outlines the guidelines for prevention and control of HCAI. As per this standard clinical leaders in collaboration with senior managers of a healthcare organisation need to implement systems for the prevention and management of healthcare associated infections. It is their responsibility to communicate the management practices to the entire healthcare workforce for achieving appropriate outcomes. As per the NHSQ Standard 3.1 better outcomes can be achieved by development and implementation of governance systems for effective infection control in order to reduce the risks of infections. Risk management approach pertaining to infection control could be taken while implementing the policies and protocols of hand washing. Such protocols would need to focus on standard infection control measures and aseptic technique. There is a need for regular monitoring of the implemented policies. The monitoring is to be done based upon effective monitoring tools. The effectiveness of the hand washing procedures has to be reviewed at the highest level of governance in the setting. Advanced actions are to be taken for improving the effectiveness of the implemented policies and procedures (safetyandquality.gov.au, 2012).

 


Research has suggested that behavioural theory framework can be utilised adequately for bringing positive changes in behaviours of individuals. This can be applied to the healthcare settings for bringing changes in the desired behaviours of the healthcare workers. With regards to the behaviour of hand washing, this theory can be applied. This approach would help to develop the knowledge translation interventions known to be more successful in bringing improvement in hand hygiene practice (Reyes Fernández etla., 2016). As stated by Al-Tawfiq and Pittet (2013) compliance rate to hand washing techniques has a major link with the system design and easy access to hand hygiene products. Healthcare worker initiative, complex behavioural considerations and system change seem to take the forefront. John Keller's (ARCS) Model of Motivational Design, Transtheoretical Model (TTM) of health behaviour change, and the theory of planned behaviour (TPB) can be applied for the promotion of hand hygiene. The TTM of health behaviour would help to tailor interventions for prediction and motivation of individual movements. A program can be constructed on the basis of the theory with intercalations with TPB and ARCS. This would strengthen the promotion of hand hygiene. An organisational cultural change would aid in this process. TPB can be modelled with the creation of peer pressure, mentoring for increased ability to overcome challenges and impartment of education that can lead to the fulfilment of the objective.

As stated by Srigley et al., (2015) with the progress of the science of hand washing procedures, better and novice ways are being implemented for avoiding the cross-transmission of pathogens that lead to nosocomial infections. Participants of healthcare settings, mainly the healthcare workers need to evaluate their performances on a regular basis in this regard. The duty of the supervisors is to monitor the changes in hand hygiene behaviours. They also have the duty to act as the role model. Maintenence of these changed behaviour is crucial on the long run, and this is a fundamental characteristic in the majority of the care settings involving the health care workers.

Nurses with proper clinical reasoning skills have the capability to have a positive impact on patient outcomes. This is important when viewed against the backdrop of increasing number of poor patient outcomes. The clinical reasoning cycle by T. Levett-Jones is a model that enables nurses to understand the patient problem and deliver the best care services.  The different steps of the clinical reasoning theory are considering the patient situation, collection of cues, processing of information, identification of issues, the establishment of goals, taking actions, evaluation of outcomes, and lastly reflection on the overall process and new learning. Following this cycle, a nurse can achieve effective hand washing procedure that can result in a better patient outcome. The patient’s condition is to be considered.  The information of the patient pertaining to risks of infection is to be collected. The information is to be processed, and the potential problems are to be identified. Establishing goals would be the next step that would make the nurse adhere to adequate hand washing procedure. The nurse would then use the suitable hand washing material and continue doing so at the required interval of time. The evaluation of the outcome would be done through assessment of the effectiveness of hand washing as indicated by the reduction of infection of the patient. Lastly,  it is necessary that the nurse reflects on the whole procedure and applies the learning to future practices (Burbach et a., 2015).

Conclusion

In conclusion, hand hygiene is a significant indicator of quality and safety of care delivered to patients in health care settings. Substantial evidence points out the correlation between the low rate of HCAI and good hand hygiene practices. Health care workers must address the issue and adhere to the set guidelines for achieving the set targets of better patient outcomes. Increased knowledge, enhanced awareness and a strong belief that the desired behaviours can be performed have the potential to bring actual changes in the present scenario.

 

References

Al-Tawfiq, J. A., & Pittet, D. (2013). Improving hand hygiene compliance in healthcare settings using behavior change theories: reflections. Teaching and learning in medicine, 25(4), 374-382.

Burbach, B. E., Barnason, S., & Hertzog, M. (2015). Preferred thinking style, symptom recognition, and response by nursing students during simulation. Western journal of nursing research, 37(12), 1563-1580.

Dai, H., Milkman, K. L., Hofmann, D. A., & Staats, B. R. (2015). The impact of time at work and time off from work on rule compliance: The case of hand hygiene in health care. Journal of Applied Psychology, 100(3), 846.

National Safety and Quality Health Service Standards. (2012). safetyandquality.gov.au. Retrieved 3 April 2017, from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf

Pan, S. C., Tien, K. L., Hung, I. C., Lin, Y. J., Sheng, W. H., Wang, M. J., ... & Chen, Y. C. (2013). Compliance of health care workers with hand hygiene practices: independent advantages of overt and covert observers. PLoS One, 8(1), e53746.

Reyes Fernández, B., Knoll, N., Hamilton, K., & Schwarzer, R. (2016). Social-cognitive antecedents of hand washing: Action control bridges the planning–behaviour gap. Psychology & health, 31(8), 993-1004.

Srigley, J. A., Corace, K., Hargadon, D. P., Yu, D., MacDonald, T., Fabrigar, L., & Garber, G. (2015). Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. Journal of Hospital Infection, 91(3), 202-210.

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., ... & Pittet, D. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.

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