During one of my clinical laboratory sessions, I witnessed a case whereby a colleague failed to observe the proper hand hygiene guidelines. She was in a hurry rushing to go and attend to a patient who needed frequent monitoring. I observed that she did not pay attention to thoroughly washing in between her fingers, partway up her wrists and under her fingernails. Additionally, she hurriedly proceeded to drying off her hands, a procedure that she carried out ineffectively. From where I was standing, I could see that her hands were still moist. She was about to make patient contact with hands that were not thoroughly washed or dried and this increased the risk of her transmitting microorganisms and bacteria to the patient. I felt that I had to do something about it so I stopped her and offered to check on her patient who I was familiar with his condition because I had already washed my hands appropriately. I advised her to carefully wash and dry her hands first then join me in checking on her patient. As I was addressing her, I noticed her long fingernails that were about ¾ inch long and advised her to particularly pay attention to washing beneath the nail tips. Care providers are supposed to maintain their nails at ¼ inch (Joy, 2012).
This incident made me feel that health care workers are constantly putting patientsat the risk of suffering from hospital-acquired infections. It is important that healthcare providers observe hand hygiene in an effective and timely manner to ensure patient safety (Hammerling, 2015). The low compliance with hand hygiene before and after making contact with a patient increases the risk of spreading microbes. These microbes are in turn capable of causing avoidable hospital acquired infections. (Pitter, 2013).
One good thing that came out of this situation is that I managed to stop the nurse from attending to a patient without observing proper hand hygiene. This may have helped prevent the transmission of bacteria to the patient. Further, I reminded the nurse to effectively carry out the hand washing routine before going to make contact with her patient. However, the nurse continued to maintain her long fingernails while attending to patients and this risked the carrying of biological contaminants under the long fingernails. I should have advised her to observe the policy that requires care providers to maintain nails at ¼ inch since hers were about ¾ inch.
Hand hygiene in the clinical setup is very important prevention of infections. Nurses should observe hand washing guidelines to prevent patients from acquiring infections. However, from this incident, I think that nurses trivialize the basic hand hygiene guidelines and this speaks volumes of their professionalism. It also undermines their regard for patient safety because they risk transmitting microbes to patients that can cause infections (Graban,2016). These infections can make patients severely ill and even cause death (Smiddy, Oconell & Creedon, 2015).
Instead of advising the nurse to pay more attention to washing beneath her long nails, I should have advised her to trim them. They were at ¾ inch and this was way above the recommended fingernails length of ¼ inch. Additionally, I should have set some time to together go through all the hand hygiene guidelines that help ensure that patient safety is upheld.
If such a situation ever arose in future, I will handle things differently. I would prioritize observing hand hygiene instead of rushing to attend to my patient. While washing my hands, I would consider the sink already contaminated and avoid touching it. I would then proceed to turn the water on with a paper towel then wet my hands and wrists. From there, I would work soap all over my hands until a lather forms and vigorously rub together all areas of my hands for 15seconds. I would pay attention to washing in between fingers, under my fingernails and partway up my wrists. I would then proceed to rinse my hands under the stream of water since the running water would carry away any dirt or debris. Finally, I would completely dry my hands with a paper towel and avoid touching any contaminated surfaces on my way to the point of care.
Gibbs model of reflection
The Gibbs reflective cycle has assisted me in reflecting and thinking through all the incidents that I have experienced throughout my development and professional practice as a student nurse. The six phases are useful in structuring the reflection of the incident and in helping people learn from these experiences (Kumar, 2016).
Graban, M. (2016). Lean hospitals: improving quality, patient safety, and employee engagement. CRC Press.
Hammerling, J.A. (2015). A review of medical errors in the laboratory and where we are today. Laboratory Medicine, 43(2), 41-44.
Joy, S. D.S (2012). Hand Hygiene in Hospitals. AJN The American Journal of Nursing, 110(7), 66-67.
Kumar, K. (2016). Reflection and its uses in Problem solving and Personal Development.
Pitter, D. (2013). Improving compliance with hand hygiene in hospitals. Infection Control & Hospital Epidemiology, 21(6), 381-386.
Smiddy, M. P., Oconell, R., &Creedon, S. A. (2015). Systematic qualitative literature review of healthcare workers’ compliance with hand hygiene guidelines. “American journal of infection control, 43(3), 269-274.