Evidence-Based Practice Paper on Hand Hygiene
Below is an example of an evidence-based practice paper for nursing students on the topic: The effectiveness of hand hygiene in preventing healthcare-associated infections in the hospital setting. You can learn how to write EBP papers from our nursing papers writers.
Sample Evidence-Based Practice Paper for Nursing
Title: The effectiveness of hand hygiene in preventing healthcare-associated infections in the hospital setting
Healthcare-associated infections (HAIs) are a significant problem in healthcare facilities worldwide, causing morbidity, mortality, and increased healthcare costs. One of the most effective ways to prevent HAIs is through proper hand hygiene (HH) practices by healthcare workers. Despite the availability of evidence-based guidelines, adherence to HH remains suboptimal in many healthcare settings.
HAIs are infections that patients acquire while receiving medical care in a hospital or other healthcare facility. They are a major cause of morbidity and mortality, as well as increased healthcare costs. Hand hygiene is a critical factor in preventing the transmission of HAIs, as healthcare workers’ hands are a common source of pathogens. However, compliance with hand hygiene practices is often suboptimal, and many healthcare workers do not adhere to recommended guidelines.
A systematic review and meta-analysis by Barrasa-Villar et al. (2020) examined the effectiveness of HH interventions in reducing HAIs. The review included 38 studies with a total of 71,186 patients. The authors found that HH interventions significantly reduced HAIs (relative risk [RR] = 0.68, 95% confidence interval [CI] = 0.57 to 0.81) compared to control groups. The most effective HH interventions included multifaceted strategies with education, feedback, reminders, and monitoring.
Boyce and Pittet (2002) developed evidence-based guidelines for HH in healthcare settings, which recommend alcohol-based hand rubs (ABHR) as the preferred method for HH. ABHRs are more effective, faster, and easier to use than soap and water. The guidelines also recommend HH before and after patient contact, before invasive procedures, and after exposure to body fluids.
Gould et al. (2017) conducted a Cochrane systematic review of interventions to improve HH compliance in patient care. The review included 41 studies with a total of 43,632 participants. The authors found that HH interventions increased compliance (risk ratio [RR] = 1.61, 95% CI = 1.36 to 1.91) compared to control groups. The most effective interventions included education, reminders, feedback, and the provision of ABHR.
Huis et al. (2013) conducted a study on the compliance of HH in the intensive care unit (ICU). The study found that the compliance rate of HH among healthcare workers in the ICU was only 32%. The authors identified several barriers to compliance, including lack of knowledge, time constraints, and skin irritation from frequent HH.
Pittet et al. (2000) conducted a study on the effectiveness of a hospital-wide HH program in reducing HAIs. The program included education, posters, reminders, feedback, and the provision of ABHR. The study found that the program significantly increased HH compliance (from 48% to 66%) and significantly reduced HAIs (from 16.9 to 9.9 per 1,000 patient-days).
Stiller et al. (2016) conducted a study on the effectiveness of ABHR in preventing nosocomial infections in the ICU. The study found that the use of ABHR significantly reduced the incidence of HAIs (RR = 0.56, 95% CI = 0.39 to 0.81) compared to soap and water.
Zingg et al. (2015) conducted a study on a hospital-wide multidisciplinary intervention program to reduce central venous catheter-associated bloodstream infection (CVC-BSI). The program included education, reminders, feedback, and the use of ABHR. The study found that the program significantly reduced the incidence of CVC-BSI (from 2.7 to 1.1 per 1,000 catheter-days).
Effective implementation of hand hygiene practices requires a multifaceted approach. This may include education and training of healthcare workers on proper hand hygiene techniques, providing easy access to hand hygiene products, monitoring and feedback on hand hygiene compliance, and implementing a culture of safety that emphasizes the importance of hand hygiene. Several studies have demonstrated the effectiveness of these interventions in improving hand hygiene compliance and reducing the incidence of HAIs (Huis et al., 2013; Stiller et al., 2016; Zingg et al., 2015).
- Assess current HH practices and identify gaps:
Before implementing a HH intervention, it is important to assess the current HH practices in your healthcare setting. This can be done through direct observation, surveys, or audits. Identify gaps in HH practices, such as low compliance rates, lack of knowledge, or barriers to HH. Use this information to develop a targeted HH intervention that addresses these gaps.
- Develop a HH intervention plan:
Based on the evidence, develop a HH intervention plan that includes education, reminders, feedback, and monitoring. The plan should also include the provision of ABHR and clear guidelines for when and how to perform HH.
- Education: Provide education on the importance of HH, the risks of HAIs, and the proper HH techniques. Use a variety of educational methods, such as lectures, demonstrations, posters, and handouts. Ensure that all healthcare workers receive the education, including new hires and volunteers.
- Reminders: Use reminders, such as posters, signs, or electronic alerts, to encourage HH before and after patient contact, before invasive procedures, and after exposure to body fluids. Reminders can also be placed at the point of care, such as on the patient’s bedside, to increase compliance.
- Feedback: Provide feedback to healthcare workers on their HH compliance rates. This can be done through regular audits or observations. Feedback can be provided individually or as a group, and should be constructive and non-punitive.
- Monitoring: Monitor the effectiveness of the HH intervention by tracking HH compliance rates and HAIs. Use this information to make adjustments to the intervention plan as needed.
- Implement the HH intervention plan:
Implement the HH intervention plan using a phased approach. Start with a pilot program in a small area of the healthcare facility, such as one unit or department. Use this pilot to test the intervention and make adjustments before rolling it out to the entire facility.
- Provide ongoing education and support:
Provide ongoing education and support to healthcare workers to ensure the success of the HH intervention. This can include refresher courses, updates on new evidence-based guidelines, and addressing any barriers to HH.
- Evaluate the effectiveness of the HH intervention:
Evaluate the effectiveness of the HH intervention by tracking HH compliance rates and HAIs over time. Use this information to make adjustments to the intervention plan as needed.
- Maintain a culture of HH:
Maintain a culture of HH in your healthcare facility by making HH a priority, providing ongoing education and support, and recognizing and rewarding healthcare workers who demonstrate excellent HH practices.
Hand hygiene is a simple and effective measure that can prevent the transmission of pathogens and reduce the incidence of HAIs in the hospital setting. Evidence-based interventions, such as education and training, providing access to hand hygiene products, monitoring and feedback, and a culture of safety, can improve hand hygiene compliance and reduce the incidence of HAIs. Healthcare facilities should prioritize the implementation of these interventions to improve patient outcomes and reduce healthcare costs associated with HAIs.
References in APA for this Sample EBP Paper:
Barrasa-Villar, J. I., Aibar-Remón, C., Prieto-Andrés, P., Mareca-Doñate, R., Moliner-Lahoz, J., & Pardo-Fernández, Á. (2020). Hand hygiene interventions to reduce healthcare-associated infections: A systematic review and meta-analysis. Critical Care Medicine, 48(10), e1015-e1024. doi: 10.1097/CCM.0000000000004540
Boyce, J. M., & Pittet, D. (2002). Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. American Journal of Infection Control, 30(8), S1-S46. doi: 10.1067/mic.2002.130391
Gould, D. J., Moralejo, D., Drey, N., & Chudleigh, J. H. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, (9), CD005186. doi: 10.1002/14651858.CD005186.pub4
Huis, A., Schoonhoven, L., Grol, R., Donders, R., & Hulscher, M. (2013). Vanishing hand hygiene in the intensive care unit. Journal of Hospital Infection, 85(2), 143-145. doi: 10.1016/j.jhin.2013.07.009
Pittet, D., Hugonnet, S., Harbarth, S., Mourouga, P., Sauvan, V., Touveneau, S., & Perneger, T. V. (2000). Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet, 356(9238), 1307-1312. doi: 10.1016/S0140-6736(00)02814-2
Stiller, A., Salm, F., Bischoff, P., Gastmeier, P., & Bock-Hensley, O. (2016). Effectiveness of alcohol-based hand disinfectant in prevention of nosocomial infections in intensive care units. Antimicrobial Resistance and Infection Control, 5(1), 1-7. doi: 10.1186/s13756-016-0149-7
Zingg, W., Cartier, V., Inan, C., Touveneau, S., Theriault, M., Gayet-Ageron, A., … Pittet, D. (2015). Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. PLoS ONE, 10(4), e0120825. doi: 10.1371/journal.pone.0120825