Getting Back to the Basics: Handwashing 101

In nursing school handwashing was first skill we learned and a skill that we demonstrated throughout the program, especially in clinical settings. As nurses’ handwashing is an essential task that must be completed many times a day to safe guard ourselves and to protect our patients. Handwashing is one of the most important way of reducing the spread of infection. However, despite the many studies and literature hand washing compliance rates remain low. Lack of hand washing compliance is a global issue. The World Health Organization has declared nosocomial infections a serious global problem. Hand washing with soap is recognized as one of the most important means of reducing spread of infectious organisms’ world- wide (Green, Kalaycioglu, Barch, et al, 2014). Each year, Healthcare Associated Infections (HAIs) affect over 722,000 patients and approximately killing 75,000 of them, in the United States alone (Musuuza et al, 2016). HAIs are among the most common preventable medical complications that result from errors and unsafe practices. Hand hygiene is known as a primary and crucial tool for reducing infections caused by health care personnel. The use of alcohol-based hand rub solutions are popular and often are used instead of washing the hands with soap and water, or sometimes HCP will use both methods for hand washing compliance. HAIs increase morbidity and mortality and length of stay, placing a great financial burden on health care services. To assist hospitals with reducing the risk of HAIs evidence-based guidelines have been introduced by multiple national and international agencies, often with a focus on the role of hand hygiene for lowering infection rates (Boyce & Pitte, 2002). Florence Nightingale’s environmental theory guided this study. Her theory changed the face of nursing to create sanitary conditions for patients to receive care and improved sanitation in the hospital setting. The goal of nursing is to facilitate a healing process by placing the patient in the best possible environment for nature to influence health (Nightingale, 1860). The purpose of this study is a twofold. First the researchers performed a systematic literature review and secondly an observational study of hand hygiene compliance was conducted using an audit tool on all health care personnel (HCP) working on units in a community hospital. HCP were observed by two auditors during rounds and unaware that hand hygiene was under observation.