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Research Proposal Hand Hygiene

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The importance of the hand washing in the care of the patient was conceptualized back in the early 19th Century. The first to provide the hand decontamination was Labarraque who reduced the incidence of the puerperal fever as well as the maternal mortality (Aiello, Coulborn, Perez, and Larson, 2008). The first clinic, which was attended by the medical student, was the Great hospital in Vienna back in 40s.  There was adapting that washing of the hands with the chlorinated lime for those leaving the autopsy room could reduce the rate of maternal mortality.

Aim, rationale

Good health has been because of combination of various aspect such as the hand hygiene. Hands are usually the most used organ of the body. Based on the recommendations, which are given by the World Health Organization, the hand hygiene is the most significance way of controlling infection especially in hospitals. Due to the critical role carried by the nurse in the patient care, they should always have essential as well updated information in regards to the hand hygiene. An individual barely passes without holding multiple objects with the hands, such as greeting people, holding money, eating and cleaning of our houses with the use of our hands. It is likely our hands are at the exposure of the germs than any other part of our body. Nonetheless, it is easy for the germs to be picked thorough our hands to other parts of the body through oral transmission. This has been because we usually use our hands, especially when eating thus we could ingest the germs with the food which we are consuming.

The organ, which is prone for the infections passed through the hands, is the stomach. Many individuals usually complain from time that they have a stomachache or perhaps they are experiencing diarrhea. All these infections are attributed from the poor hand hygiene, and it is significant to maintain good hygiene through constant washing of the hands using medical hand wash such as Dettol hand wash, which should be done before or perhaps after using hands in various activities. This ensures that the hand are always clean and there are no germs, which are transferred to the hands into our mouth especially when we are eating. The hand hygiene should always start from the health professionals, such as the nurses who are experts and they are expected to show a good example to the patients. This paper will be expected to research on the standards of the nurses hand hygiene in a New York hospital.


Purpose of the statement

The nurses as the health professionals are entitled to always promote the health living practices of all the citizens. One way they could achieve this is through promoting of practices of proper hygiene such as the hand hygiene. These practices should be carried out both in the place of work and at home. The nurses should act as the ambassadors of promoting of good hygiene practices. The patients could easily copy what the nurses are undertaking in the hospital and in return, they are able to reduce the chances of getting infections in order to ensure there is no proper hygiene. This research will undertake a research on the hygiene practices of the nurses in New York hospital on whether they are advocating good hygiene or if they are not. Provision of a good example to the patients and other citizen shows that the nurses are following ethical practices and they are advocating for the changes to reduce on the infection, which result from poor hygiene.

Significance of maintaining hand hygiene

Hand hygiene helps the patients to keep away from the ailments, which result from the poor hand hygiene. This will help to save on the costs of treatment as well as increase productivity from the population who are healthy due to maintained health status. Therefore, having a proper hand hygiene is the most significant yet simplest as well as least expensive method of reduction of the prevalence of ailments. There are several studies which have highlighted that hand washing is the vital way of elimination of pathogens on the hands which ultimately reduce on the rate of the ailments.

Statement of the problem

The hypothesis of the project proposal: has most nurses in the New York hospital facility embraced the proper hygiene practices such as washing of hands.

There has been a rise in the number of infections, which have resulted from improper hygiene of the hand in the New York of recent. The nurses have also not been left from the infections an example two nurses have been admitted to the facility and they were complaining of the severe stomach pains, of which these ailments have resulted from using unclean hands when ingesting of the food. This has raised a health concern in the hospital. In such an occurrence if such ailment could sweep the health professional there are a high chance it will happen the same to the other citizens. There has been many expenses which have been incurred especially for the treatment of such ailments due to poor hand hygiene.

The cause, which has been associated with this situation, is due to the poor hand hygiene.  Many stomach infections result from the ingesting germs into our body system through the food that is eaten. The hands are the organs, which are used for eating, and the germs could be picked through the hands and transferred to the mouth as one eats. In one do not maintain proper hygiene then there is a risk of infection. If these occurs the government will be forced to channel, many resources towards treatment of these infections that could arise which otherwise could have been prevented at no cost.

A high number of individual who are suffering from an infections result to low productivity in the workforce, standards of living of these individuals also deteriorate and these individuals are not able to meet there daily needs (World Health Organization, 2009). Many may perceive hand hygiene as just a trivial matter, but the effects from improper hygiene could cause ramification impact to many people who are affected. Infection usually inflict a lot of suffering as well as threaten the general body functions. The benefits of preventing these infection is important; this should begin with the health professional who act as an example to the patients.


Method of the research

The research follows theorist approach, which is the nursing theories called Dorothea Orem self-care theory.  The self-care has been regarded are those personal practices which could be done independently in order to promote the health of an individual, such as hand washing. Most people could assume it just as a mere practice but it could save one some cost. It can only be achieved when a person has an agency with the self-care (World Health Organization, 2012). An individual should have a personal initiative in order to perform the self-care practices and if deficit occurs, it could lead to self-care, which can cause ill health of a person.

When one become sick, the nurse should be expected to meet all the healthcare needs of the patients and teach, give support and provide an environment, which is good for them to achieve self-care practices (Pittet, Hugonnet, Harbarth, Mourouga, Sauvan, Touveneau and Perneger, 2000). Moreover, the nurse could also provide a compensatory package to help the patient to fully recover (O'Boyle, Henly and Larson, 2001). The patient could be helped in achieving of the self-care through setting a good role model to them. The nurses are usually the first individuals to embrace self-care practices to the patients and it is expected of them to do all they can for the patients to enable them to feel better.

Literature review

On the literature review, I have reviewed journal, which relates to the hand hygiene of the health care experts. In accordance to Larson (1995), highlights the guidelines, which the nurses should use in order to ensure hand hygiene is maintained. Moreover, he has also recommended that the nurses should set good examples to the patients as well as other citizens. The nurses should always observe a good hand hygiene, through washing of hands with the use of recommended antiseptics that could destroy the germs that are on the hands (World Health Organization, 2012). The author has also highlighted difference cases of infections to the healthcare provides which results to poor hygiene (Sax, Allegranzi, Uckay, Larson, Boyce and Pittet, 2007). This should set example to the patients on the best standards, which are expected in order to be able to curb the ailments. Further, in accordance to Pittet and Boyce (2002), highlights that hand washing is one of the most efficient as well as an effective way of preventing of the infections. Most of the stomach ailments usually results from the poor practices of washing of the hands. Many individuals including the health professionals usually ignore this especially when one leaves the toilet (Whitby, Pessoa-Silva, McLaws, Allegranzi, Sax, Larson, Seto, Donaldson and Pittet, 2007). The author highlights that before one eats the food they should wash their hands well. Additionally, the nurses should be at the forefront to make sure patients are provided proper self-care practices ( Boyce, J.M., 1999). An experiment, which had been done by Hazy and Wang (1998), in a hospital showed that even the nurses themselves do not observe good self-care especially washing of the hands. The observation, which was made, was that the nurses did not always wash hands when they left the restroom. The effect of this situation could worsen to the patients because the nurses used the same hands to administered prescriptions to the nurses and if they hand germs it could be transferred to them. Based on the survey carried out in a hospital by Perneger and Mourouga (1999) to educate the nurses showed that the instructors as well as the trainee nurses were not observing proper hand hygiene. This clearly showed that it is not a good example to the patient since they are bound to show proper practices as healthcare providers. In accordance to Pittet (2000), he has provided some recommendations on ways the healthcare providers in healthcare could improve on the hand hygiene. Such recommendation are the hygiene standards in the hospital should be very high in order for the patients to learn from the same. The nurses could offer the guidelines, as well as educate the patient on how they could improve on their self-care practices.


Expected outcome/results

It is expected that the nurses in New York hospital facility do not observe hygiene hand wash requirements as required. The basis of this point is the situation few months ago observed of the nurses who were suffering from the stomach ailments in the hospital, hand-washing practice in the hospital is indeed in doubt (Lankford, Zembower, Trick, Hacek, Noskin and Peterson, 2003). Moreover, it is also very evident that there is a high increase in the cases of the stomach ailments admissions to the hospital. This shows the hospital has not embraced full the campaign of promoting a health hygiene practices. Based on the review of the literature it has clearly showed that many of the nurses are reporting just the practices of the hand hygiene to the patient but they themselves are not embracing what they stand for. It is also expected based on the literature that the nurses have not complied fully the concepts of self-care.


Design of the research

Carrying of this research undertaking will be the nurses in central New York health facility. The data collection will take approximately a week. There would be a preliminary visit to the health institution prior before carrying the research (Pittet, 2001). Ten nurse will be randomly selected for the research from the population of the nurses in the hospital. The collection method for the data will be through interviews and observation (Haas, and Larson, 2007). The interviews carried out will be on the issues of the compliance to the self-care requirements. The washing of the hand patterns of the nurses will be observed  especially the ones who are leaving areas such as rest room, or perhaps during meals as well as when the patients are being administered the drugs. The information gotten will be recorded in the note for the purpose of the analysis. Through use of the tables will be undertaken in order to show compliance of the nurses who wash hands to the various subsections of observations (Haas and Larson, 2007). After carrying of the analysis, it would be projected to the entire population basing on the compliance of the nurses to wash hands. There would be a move on how these nurses promote the health care practices to the patients and a level indicated on each one of them. Recommendation will also be provided on how to improve the self-care of the patients.


The practice of hand hygiene has been one of the self-care requirement, which can go a long way especially when keeping most of the infections at a bay. It is the work of the nurses to work relentlessly in order to promote self-care practices and they should set a good example to the patients on hand hygienic. In maintaining a population that is, healthy there would be achievement of economic growth which will be realized from individuals who are energetic and resources which would have been channeled to the health sector would be devoted to other sectors.



Aiello, A.E., Coulborn, R.M., Perez, V. and Larson, E.L., 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. American journal of public health, 98(8), pp.1372-1381.

Boyce, J.M., 1999. It is time for action: improving hand hygiene in hospitals. Annals of internal medicine, 130(2), pp.153-155.

Haas, J.P. and Larson, E.L., 2007. Measurement of compliance with hand hygiene. Journal of Hospital Infection, 66(1), pp.6-14.

Lankford, M.G., Zembower, T.R., Trick, W.E., Hacek, D.M., Noskin, G.A. and Peterson, L.R., 2003. Influence of role models and hospital design on hand hygiene of health-care workers. Emerging infectious diseases, 9(2), pp.217-223.

Pittet, D., Hugonnet, S., Harbarth, S., Mourouga, P., Sauvan, V., Touveneau, S. and Perneger, T.V., 2000. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet, 356(9238), pp.1307-1312.

Pittet, D., 2001. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerging infectious diseases, 7(2), p.234

O'Boyle, C.A., Henly, S.J. and Larson, E., 2001. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. American journal of infection control, 29(6), pp.352-360.

Sax, H., Allegranzi, B., Chraïti, M.N., Boyce, J., Larson, E. and Pittet, D., 2009. The World Health Organization hand hygiene observation method. American journal of infection control, 37(10), pp.827-834.

Whitby, M., Pessoa-Silva, C.L., McLaws, M.L., Allegranzi, B., Sax, H., Larson, E., Seto, W.H., Donaldson, L. and Pittet, D., 2007. Behavioural considerations for hand hygiene practices: the basic building blocks. Journal of Hospital Infection, 65(1), pp.1-8.

World Health Organization, 2012. Hand hygiene in outpatient and home-based care and long-term care facilities: a guide to the application of the WHO multimodal hand hygiene improvement strategy and the “My Five Moments For Hand Hygiene” approach.

World Health Organization, 2009. WHO guidelines on hand hygiene in health care: first global patient safety challenge. Clean care is safer care. World Health Organization.

Sax, H., Allegranzi, B., Uckay, I., Larson, E., Boyce, J. and Pittet, D., 2007. ‘My five moments for hand hygiene’: a user-centred design approach to understand, train, monitor and report hand hygiene. Journal of Hospital Infection, 67(1), pp.9-21.

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