The most effective measure of preventing and controlling the spread of infections is efficient hand hygiene. Handwashing is very important in every setting where people are cared for, especially in hospitals, as most infections are transmitted to patients directly via the hands of health care workers (Kozier & Eb, 2002). This essay is going to illustrate the importance of correct handwashing by explaining the potential consequences of the lack of hand hygiene, its growing importance in history, the goal of hand disinfection and its techniques.
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The hands become contaminated through contact with patients, colleagues, items near the patients, like bedding, and also by equipments used by the staff such as computer keyboards. The best way to break the infection-chain is cleaning the hands in order to destroy the microorganisms which are responsible for health-care-associated infection (HCAI). This infection is the most common complication affecting hospitalized patients. Not all infections are preventable but many could be avoided by the proper hand hygiene among staff (Vincent, 2006). It is therefore the responsibility of all health care workers to clean their hand effectively for infection prevention and they have to do it so even if they were wearing gloves (Gould, 2009).
By the middle of the nineteenth century, anaesthesia allowed more time for the doctors to operate patients in a careful and purposeful manner, however, infection rates in the hospitals were very high. For example, puerperal fever among mothers after childbirth was higher than among those who delivered at home. It was suspected by some doctors that the reason of this might be the transfer of bacteria. Real significant evidence of the importance of hygiene was provided by the Hungarian physician Ignac Semmelweiss, who introduced hand disinfection standards, including hand washing with chlorinated lime solution (Vincent, 2006).
Considerable improvements in the area of hand hygiene only later, with experimental support from the work of Pasteur and Koch, the principles of infection control and new sterilization techniques of health care equipments, were established. Even so, with these daysââ‚¬â„¢ understanding of infection transmission, the health care arena faces an epidemic of HCAI (Vincent, 2006). The groups that have the highest risk of infection are including, but not limited to the elderly, the very sick and the very young (Gould, 2009).
The consequences of HCAI could be extended hospital stay, long-term disability, increased resistance of microorganisms to antimicrobials, extra cost for the NHS, the patients and their families, and excess deaths (WHO, 2009). The causes of these infections are complex, from overcrowded hospitals to the lack of easily accessible hand washing facilities, just to mention a few. Didier Pittet eased this matter by introducing a new form of hand disinfection, which was an alcohol-based rub (Vincent, 2006).
While it is known that well-informed health care professionals would improve the hand hygiene compliance, some teaching methods are not supporting the improvement of behaviour change. Hand hygiene is consistently practised more effectively after patient care than it is before that (Bearman et al, 2007, cited in Cole, 2009). However, there is no lack of policies and guidelines regarding infection control in health care institutes; to improve the low compliance is up to the health care staff and their incorporation of these regulations into practice (Storr and Clayton-Kent, 2004).
Hand washing has attracted a strong body of research. Studies on hand hygiene compliance suggest that in an average hospital ward the health care staff clean their hands less than half as often as it would be required to maintain patient safety regarding cross-infection (Storr and Clayton-Kent, 2004). The goal of hand disinfection on the wards is to remove transient microbes and avoid them to be transferred to the patient (Gould, 2009). There are two kind of microbes can be found on human skin: resident and transient microbes. The resident microbes live on the skin and they are the part of the bodyââ‚¬â„¢s defensive system, while the transient microbes are only ââ‚¬Å“visitorsââ‚¬, people acquire them through their day-to-day activities and cause hand contamination. As some of them can live on the hands for hours, transferring them are quite simple (Mackintosh and Hoffman, 1984, cited in Storr and Clayton-Kent, 2004).
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As mentioned earlier, hand hygiene is important even if gloves have been worn. It is so because sweating of the hands is increased while wearing them and this way bacterium is drawn out from the fingernail and the deeper skin areas, making the risk higher of cross-infection to the patient. This danger still exists after the removal of the gloves as the hand can contact with the surface of the gloves (Gould, 2009).
Hand washing can be carried out in different ways. When using water and soap, even though many of the transient microbes will be removed, they will not be destroyed because soap does not have bactericidal activity. On the other hand, alcohol kills bacteria but some of its ingredients (chlorhexidine) will continue to do so after the usage for some time. When using water for hand washing, it is important to use a sink with elbow or foot-operated taps as well as thorough drying of the hands after it because it is harder to transfer for micro-organisms on a dry surface than on a wet one (Gould, 2009). As frequent hand washing can damage the skin, moisturizing the hand with lotion after it can help protect the skin from drying out (Kozier & Eb, 2002).
At the individual level, health care professionals must know and believe the high importance of hand hygiene for infection prevention and make it as a regular and essential part of their daily routine. At the institutional level, hand disinfection must be one of the priority objectives and make an effort to involve the health care workers actively of infection control (Cole, 2009). Good hand care should continue outside work as well, as risks for cross-infection can be found everywhere.
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