Hand sanitation has long been known to reduce the spread of disease and today alcohol based hand sanitizers are used in addition to washing hands with soap and water. Currently there are evidence based practices (EBP) guidelines for hand sanitization versus hand washing for bedside nurses. There’s currently significant evidence for using one method over the other but some barriers prevent the proper level of sanitation.
Significance to Practice
Healthcare acquired infections (HCI) are very common in today’s hospitals and new forms of drug resistant organisms have emerged limitation of the spread of these organisms are of great significance. Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Clostridium difficile(CDIF), surgical site infections, urinary tract infections, and ventilator related pneumonias are common HCI’s. Surgical site infections alone according to an annual report from the Colorado Department of public health estimates national financial toll of 3-10 billion dollars.
Some common barriers to healthcare workers can be cost, access to hand sanitation stations or materials and lack of knowledge of current best care practices. Lack of proper hand hygiene increases the likely hood of a healthcare acquired infection. Cost to the hospital and the patient increases with longer hospital stays and more treatment required. Current practices should not be changed but education in the reasoning of these practices needs to be increased in the healthcare community.
Several articles specifically address not just hand hygiene but specifically hand washing or the use of alcohol based hand sanitizers.
Article 1: “Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence” examined EBP and four common practices in particular the discussion of Health care acquired infections (HCAI’s) are preventable with consistent use of interventions such as hand washing. The article further explains the regulations in place are so important today that hospitals may not be reimbursed if HCAI’s occur and interventions were not performed properly or provided. The author’s explain the rationale for hand hygiene based off of the World Health Organization (WHO) guidelines where the healthcare provider acts as the primary means of spreading organisms. The author cites percentages of healthcare providers compliance as low as 5% and as high as 89% with a mean of 50%. The author also notes that organisms can be spread even with no patient contact particularly Clostridium difficile which is known to spread not just on hands but by way of thermometers and blood pressure cuffs. This fact is even more important as noted in another article that C. Dif spores are not killed by alcohol based hand sanitizers but must be physically scraped from the skin mechanical by means of hand washing (WHO,2009). The author concludes with statements promoting EBP use and to...