RESPONSE TO PEER DISCUSSION

What is the effectiveness of using alcohol-based solution in hand hygiene based on CDC guidelines in reducing nosocomial infection on an oncology unit compared to routine soap and water hand washing?

Importance in the Nursing Practice and Health Outcome

Infection Related to Healthcare (IRAS) results from the acquisition of any pathogenic microorganism through invasive, therapeutic or diagnostic procedures performed without technical rigor at any level of care by health professionals. It was an important public health problem since the establishment of the first hospitals when there was still no scientific and microbiological knowledge, as well as the principle of disease transmission. (De Oliveira Dourado, Da Costa Barros, Diogo de Vasconcelos & Da Silva Santos, 2017) Today, Bucher, Donovan, McCoy, and Ohman-Strickland’s (2015) identify that healthcare worker compliance with hand hygiene remains a pervasive problem in medicine. The lack of hand hygiene compliance results in transmission of community acquired and hospital acquired microorganisms between both patients and providers, which can lead to nosocomial infections. This chain of transmission is closely related to deficiency in a correct practice, and adherence to routine hand washing since although this technique is recognized as the most important and efficient preventive measure in reducing the transmission of microorganisms, adherence of health professionals is still very poor.

Barriers Nurses Might Encounter While Exploring This Problem

Reasons reported by health-care workers for the lack of adherence with recommendations include skin irritation, inaccessible supplies, interference with worker-patient relation, patient needs perceived as priority, wearing gloves, forgetfulness, ignorance of guidelines, insufficient time, high workload and understaffing, and lack of scientific information demonstrating impact of improved hand hygiene on hospital infection rates. A recent review determined that a successful hand hygiene educational program has several key features. These features include reinforcement of hand hygiene messages; knowledge of health care workers’ perceived importance of hand hygiene and its role in prevention of healthcare-associated infections; monitoring and feedback of hand hygiene practices; practical education tools; role-modeling by senior staff; and supportive infrastructure and management.

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