Hand Hygiene in Healthcare Organizations Samples †MyAssignmenthelp.co

Question: Discuss about the Hand Hygiene in Healthcare Organizations. Answer: Introduction and Background In the process of providing care services in the healthcare organizations, hand hygiene is a prime and vital measure required in the hospitals for the purpose of minimizing the risk of transmission of infections. While providing care service to the patients nurses are observed to have high frequency of contact with the care users. Nurses play an integral role in minimizing the healthcare issues associated with risk related to hand hygiene. Thus, the core emphasis of the assignment would be on identifying strategies for the purpose of enhancing hand hygiene and discussing the implications of its implementation. Body Enhancement of hand hygiene among the health care professionals is a basic measure required to be undertaken for the purpose of minimizing healthcare related infections in hospitals. For the purpose of enhancement of hand hygiene techniques in the health care organizations in the year 2009, new global guidelines comprising of five critical moments associated with hand hygiene has been adopted on the part of WHO (White et al., 2015). The set of guidelines adopted on the part of WHO has been reworded by Hand Hygiene Australia which comprises of five moments- (Moment 1) prior touching a patient, (Moment 2) before procedure, (Moment 3) post procedure, (Moment 4) after the contact to a patient and (Moment 5) after touching the surrounding of a patient (World Health Organization, 2009). On the basis of the Australian data highlighting on rate of compliance with the five moments in hospitals demonstrated high compliance with the moments, with limited compliance to Moment 5 which deals with hand hygiene post contact to a patients surrounding (Pittet et al., 2010). This clearly indicates the scope and requirement of performance and compliance of hand hygiene practice. It is mentionable here that other than employees of the healthcare organizations, nurses are seen to play an integral role in the aspect of minimizing heath related infections. In addition to it, maximum physical contact with patients is experienced on the part of the nurses, which makes them associated with the risk of transmission of infection (Erasmus et al., 2010). This makes it essential to recognize the determinants of hand hygiene decision within the hospital based nurses which make it essential to inform intervention strategies for the purpose of motivating greater level of compliance. In order to enhance hand hygiene compliance, there are certain strategies which can be implemented in the health care organizations facing such issues. In this context it can be stated here that apart from various environmental and structural aspects impacting the hand hygiene decisions on the part of the nurses like accessibility of hand hygiene products, work load etc. These actions on the part of the nurses are seen to be determined by the beliefs of individuals along with their perceptions associated with hand hygiene and its performance (Gould et al., 2010). There are various theoretical approaches which evaluates the socio-cognitive mechanisms at the edifice of the decision making process for health behavior, the application of which would act as a contributing factor in perceiving the aspect of compliance with hand hygiene guidelines on the part of nurses. Some of the mentionable approach in this aspect is social cognitive theory and health belief model (Aiello et al., 2010). Considering the above mentioned aspect, one of the mentionable strategies which can be implemented in the health care organizations for enhanced level of compliance with the hand hygiene guidelines is theory of planned behavior [TPB] Al-(Tawfiq et al., 2013). It is an effective and commonly used decision-making model. With the help of implementation of this model, the role of social influences in addition to personal perceptions and attitudes related to management of behavior can be perceived (White et al., 2015). This would act as a contributing factor in ascertaining enhanced level of compliance with guidelines associated with it on the part of the nurses. The reason being, the healthcare professionals including nurses works within a group wherein the influence are seen to impact the decision of other members within the group (Marra et al., 2011). In such cases, the implementation of TPB is efficacious. Under the particular strategy, it has been stated that the motive to perform a particular behavior is the best interpreter of behavior. In this context, the element of intention is determined with the help of three factors which includes attitude, subjective norm and perceived behavioral control [PBC] (Montano Kasprzyk, 2015). The particular strategy also puts forward the fact that the background of any particular attitude, PBC and subjective norm are consequent of the particular beliefs demonstrating the intention and behavior of an individual. It is required to be mentioned here that, for the purpose of prompting change so that intentions that are positive in nature gets translated into continuous behavior, acknowledging the determinants of intention which is significant in nature so that the identified factors and the related beliefs formulating these constructs can be emphasized to bring in desired change with the help of implementation of this strategy it becomes possible (Ajzen, 2011). In the context of the healthcare organizations emphasizing on hand hygiene decisions, the implementation of this model can turn out to be highly beneficial. Thus, as there are direct link between individuals knowledge of hand hygiene and its compliance, it is with the help of implementation of this strategy the decision making process of the nurses can be influenced particularly after the influence of a new initiative wherein staff training and awareness training occur to educate employees regarding new regime (De Wandel et al., 2010).. The implementation of this model also results in subjective and objective levels of knowledge which is significant in impacting nurses regarding hand hygiene adherence. In addition to the above mentioned aspect, with the help of implementation of the strategy, health education strategies can be made well informed for the nurses, which help in enhancement level of compliance to hand hygiene among the nurses. It helps in promoting the required behavior among the nurses for compliance with hand hygiene guidelines as we ll as help them overcome the barrier associated with compliance with hand hygiene guidelines like lack of time (Milton Mullan, 2012). Other than that, as it modifies the behavioral pattern within the group with making positive impact on their behavior and decision making process, it would also result in enhanced level of compliance and adherence to the guidelines associated with it along with compliance to the five moments an dissemination of information associated with it. Apart from the above mentioned strategy with the help of which the perception and awareness associated with hand hygiene can be enhanced, in order to enhance hand hygiene compliance in the healthcare setting, another mentionable strategy is, implementation of observation methods in the healthcare organizations (Randle et al., 2010). Within the strategy of observation methods, there are diverse observation methods which contribute to compliance to the hand hygiene standard in different manner. One of the mentionable method under the strategy of observation methods is direct observation. With the help of implementation of this observation method, adherence to the hand hygiene standard can be ensured (Allegranzi et al., 2013). It is the only method with the help of implementation of which every opportunity associated with hand hygiene can be distinguished within the process of patient care along with assessment of hand hygiene technique, which provides with the opportunity of immediate corrective feedback (van de Mortel et al., 2010). Another mentionable technique in this context is technology assisted direct observation, wherein technology is used to save the steps associated with entered data along with providing the observer with the opportunity to standardize the measurement (Jang et al., 2010). Herein it is mentionable that with the help of video assisted observations gives the scope of conducting assessment all opportunities at even remote location. Moreover, it is less time consuming in nature which helps in performing this observation technique. An impactful technique associated with observation method is event count measure or product volume. The major advantage associated with this technique is it is not subjected to Hawthorne effective along with observer or selection bias (Ellingson et al., 2014). Other than the above mentioned aspect the technique is free from any kind of obstruction associated with observation and comprises of every required opportun ities for observation. Changes can also be detected on the part of the counters in terms of frequency of use in accordance to patterns or time of day of use in the healthcare organization (Helder et al., 2010). It also helps in providing with assistance in best location of dispensers. In the process of application of observation methods, advanced technologies associated with automated monitoring is also applicable. In the particular technique systems with wearable components can act as a contributing factor in providing with positive feedback or timely reminder for the purpose of ascertaining hand hygiene along with individual level monitoring (Grayson et al., 2011). It also helps in capturing all events which includes leaving and entering a patient zone and related set of guidelines. Self report is also applicable in this context which acts as a contributing factor in enhancement of awareness of individuals regarding their practices (Helms et al., 2010). Thus, with the help of appl ication of the above mentioned strategies within the healthcare organization, on the part of care professionals which also include nurses, enhanced level of compliance with the guidelines of hand hygiene can be ensured. With the help of application of the above discussed strategies associated with enhancing compliance with hand hygiene guidelines, the standards provided under National Safety and Quality Health Service Standards [NSQHS] can be particularly complied upon. To get in depth of the matter, under the provision of NSQHS Standard 1 it has been stated that quality and safety framework stating the expected processes and structures of a safe organization has been provided. To get in depth of the matter, under standard 1, health service organizations have formulated and executed educational materials, policy and processes for enhancement which includes mortality review, credentialing, root cause analysis, incident monitoring. Thus under this standard, the safety of the patients against harm have been ensured, wherein, within the help of its implementation, the care users receive the highest standard of care (safetyandquality.gov.au, 2012). In this context, the second, proposed strategy of observ ation method is in alignment, which proposes measures of observing and monitoring compliance with hand hygiene strategies, which is also mentioned in the standard 1of NSQHS that highlights on incident monitoring. Similarly, the first strategy of TPB is also in alignment with standard 1of NSQHS, which mentions bringing positive change and promoting positive behavioral pattern among the professionals to ensure compliance with hand hygiene standards (Huis et al., 2012). As a result of implementation of the strategy of TPB, the awareness level within the professionals also enhances, which is also the emphasis of standard 1of NSQHS i.e. to enhance the level of awareness within the health care system and ascertain safety of the care users. Other than that, under standard 1 of NSQHS criterion to be achieved has been dealt with, which have highlighted on undertaking regular clinical audits and reviewing performance data, implementation of performance management procedure which is also seen to be in alignment with the second strategy of observation method (Twigg, Duffield and Evans, 2013). In addition to the above mentioned aspect, the criteria to be achieved section of standard 1of NSQHS can also be associated with the first proposed strategy i.e. TPB as the criterion to be achieved section of standard 1of NSQHS emphasizes on informing and communicating the non-clinical and clinical workforce which would help in bringing positive change among them towards compliance of the standard which is also the purpose of TPB. Standard 3 of NSQHS is also seen to be in alignment with the two proposed strategies (Morgan et al., 2012). To elaborate the issue further, under this standard of NSQHS emphasis has been given on range of strategies like collaborative approach at every level of healthcare system which requires positive approach towards complying the standards which is in alignment with the strategy of TPB. Under this strategy emphasis has also been given on hand hygiene sur veillance and enhancing the required use of antimicrobials making it in alignment with the strategy of observation method (Marra et al., 2010). The alignment of Standard 3 of NSQHS with strategy of observation method can be further observed from the stated criterion to be achieved, wherein emphasis has been given on procedures of regularly monitoring and performing risk management in the functioning of healthcare system, healthcare infections surveillance, effectiveness of infection control and prevention systems, undertaking quality improvement activities and implementing and auditing hand hygiene program making it in alignment with observation method (Grant Hofmann, 2011).. Thus the above made discussion clearly reflects the correlation of the two strategies of observation method and TPB with NSQHS reflecting the fact the effective implementation and compliance of the strategies would in turn result in compliance with the legislation and set of guidelines of hand hygiene like tha t of NSQHS. The implementation of the two strategies of TPB and observation method will have impact on the healthcare organization. With the help of implementation of TPB within the ward of the healthcare organization, positive approach, awareness can be brought within the professionals which would help in ascertaining compliance with the hand hygiene legislation (Pincock et al., 2012). It can be effectively implemented within the ward with the help of group meeting, conducting awareness and training sessions which would have positive impact on the behavioral pattern of the professionals. However, the major issue associated with strategy is the fact that it is exposed to inclusion of the additional prejudices and perceptions which are difficult to alter, making the strategy ineffective in nature in these cases (Lee et al., 2011). The major facilitator of this strategy is the aspect, that with the help of changing the behavioral approach of an individual within the healthcare setting, the behavio ral pattern of the other members of the team can be also be impacted positive (Marra et al., 2013). Moreover, such influences within particular member of the team can be easily disseminated within other team members making it easy to be implemented (Park et al., 2010). Similarly, with the help of implementation of the strategy of observation methods monitoring of the compliance with the hand hygiene standard can be ensured without informing the individuals who are being observed, on the basis of which actions can be taken towards its compliance. In order to implement the strategy, observation methods with the help of the methods- direct observation, technology-assisted direct observation, event count or product volume, advanced technologies for automated monitoring and self report it can be implemented (Cheng et al., 2011). The major advantage of this strategy is, it is not subjected to any kind of biasness, Hawthorne effective, less time consuming and accurate in nature. However, t he main challenge associated with the strategy is requirement of training to be effectively implemented, requirement of investment, expensive in nature (Sahud et al., 2010). Thus, it can be stated that, though, there are certain challenges associated with the implementation of the above discussed strategies, but this cannot be ignored that, with the effective implementation of the strategies, compliance with hand hygiene strategies like NSQHS. Conclusion Thus, in the conclusion it can be stated that, the aspect of hand hygiene is an integral part of providing effective healthcare services. However, for it to be effectively complied and implemented, formulating legislations and policies is not enough. Changes are required to be brought at every strata of the healthcare organization towards maintaining hand hygiene, then only the policies and legislations can be effectively implemented and abided. References Aiello, A. E., Murray, G. F., Perez, V., Coulborn, R. M., Davis, B. M., Uddin, M., ... Monto, A. S. (2010). Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. Journal of Infectious Diseases, 201(4), 491-498. Ajzen, I. (2011). The theory of planned behaviour: reactions and reflections. Allegranzi, B., Gayet-Ageron, A., Damani, N., Bengaly, L., McLaws, M. L., Moro, M. L., ... Donaldson, L. (2013). Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. The Lancet Infectious Diseases, 13(10), 843-851. Al-Tawfiq, J. A., Abed, M. S., Al-Yami, N., Birrer, R. B. (2013). Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. American journal of infection control, 41(6), 482-486. Cheng, V. C., Tai, J. W., Ho, S. K., Chan, J. F., Hung, K. N., Ho, P. L., Yuen, K. Y. (2011). Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO" My 5 Moments for Hand Hygiene" methodology. BMC infectious diseases, 11(1), 151. De Wandel, D., Maes, L., Labeau, S., Vereecken, C., Blot, S. (2010). Behavioral determinants of hand hygiene compliance in intensive care units. American Journal of Critical Care, 19(3), 230-239. Ellingson, K., Haas, J. P., Aiello, A. E., Kusek, L., Maragakis, L. L., Olmsted, R. N., ... VanAmringe, M. (2014). Strategies to prevent healthcare-associated infections through hand hygiene. Infection Control Hospital Epidemiology, 35(08), 937-960. Erasmus, V., Daha, T. J., Brug, H., Richardus, J. H., Behrendt, M. D., Vos, M. C., van Beeck, E. F. (2010). Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infection Control Hospital Epidemiology, 31(03), 283-294. Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H. (2010). Interventions to improve hand hygiene compliance in patient care. The Cochrane Library. Grant, A. M., Hofmann, D. A. (2011). Its not all about me motivating hand hygiene among health care professionals by focusing on patients. Psychological science, 0956797611419172. Grayson, M. L., Russo, P. L., Cruickshank, M., Bear, J. L., Gee, C. A., Hughes, C. F., ... Selvey, C. E. (2011). Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative. Med J Aust, 195(10), 615-9. Helder, O. K., Brug, J., Looman, C. W., van Goudoever, J. B., Kornelisse, R. F. (2010). The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison. International journal ofnursing studies, 47(10), 1245-1252. Helms, B., Dorval, S., Laurent, P. S., Winter, M. (2010). Improving hand hygiene compliance: a multidisciplinary approach. American journal of infection control, 38(7), 572-574. Huis, A., van Achterberg, T., de Bruin, M., Grol, R., Schoonhoven, L., Hulscher, M. (2012). A systematic review of hand hygiene improvement strategies: a behavioural approach. Implementation Science, 7(1), 92. Jang, T. H., Wu, S., Kirzner, D., Moore, C., Youssef, G., Tong, A., ... McGeer, A. (2010). Focus group study of hand hygiene practice among healthcare workers in a teaching hospital in Toronto, Canada. Infection Control Hospital Epidemiology, 31(02), 144-150. Lee, A., Chalfine, A., Daikos, G. L., Garilli, S., Jovanovic, B., Lemmen, S., ... Rubinovitch, B. (2011). Hand hygiene practices and adherence determinants in surgical wards across Europe and Israel: a multicenter observational study. American journal of infection control, 39(6), 517-520. Marra, A. R., Guastelli, L. R., de Arajo, C. M. P., dos Santos, J. L. S., Lamblet, L. C. R., Silva, M., ... Barbosa, L. (2010). Positive Deviance A New Strategy for Improving Hand Hygiene Compliance. Infection Control Hospital Epidemiology, 31(01), 12-20. Marra, A. R., Guastelli, L. R., de Arajo, C. M. P., dos Santos, J. L. S., O Filho, M. A., Silva, C. V., ... Edmond, M. B. (2011). Positive deviance: a program for sustained improvement in hand hygiene compliance. American journal of infection control, 39(1), 1-5. Marra, A. R., Noritomi, D. T., Cavalcante, A. J. W., Camargo, T. Z. S., Bortoleto, R. P., Junior, M. S. D., ... dos Santos Cardoso, M. F. (2013). A multicenter study using positive deviance for improving hand hygiene compliance. American journal of infection control, 41(11), 984-988. Milton, A. C., Mullan, B. A. (2012). An application of the theory of planned behaviora randomized controlled food safety pilot intervention for young adults. Health Psychology, 31(2), 250. Montano, D. E., Kasprzyk, D. (2015). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health behavior: Theory, research and practice. Morgan, D. J., Pineles, L., Shardell, M., Young, A., Ellingson, K., Jernigan, J. A., ... Perencevich, E. N. (2012). Automated hand hygiene count devices may better measure compliance than human observation. American journal of infection control, 40(10), 955-959. Park, J. H., Cheong, H. K., Son, D. Y., Kim, S. U., Ha, C. M. (2010). Perceptions and behaviors related to hand hygiene for the prevention of H1N1 influenza transmission among Korean university students during the peak pandemic period. BMC Infectious Diseases, 10(1), 222. Pincock, T., Bernstein, P., Warthman, S., Holst, E. (2012). Bundling hand hygiene interventions and measurement to decrease health careassociated infections. American journal of infection control, 40(4), S18-S27. Pittet, D., Simon, A., Hugonnet, S., Pessoa-Silva, C. L., Sauvan, V., Perneger, T. V. (2010). Hand hygiene among physicians: performance, beliefs, and perceptions. Annals of internal medicine, 141(1), 1-8. Randle, J., Arthur, A., Vaughan, N. (2010). Twenty-four-hour observational study of hospital hand hygiene compliance. Journal of Hospital Infection, 76(3), 252-255. safetyandquality.gov.au. (2012). National Safety and Quality Health Service Standards. [online] Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf [Accessed 20 May 2017]. Sahud, A. G., Bhanot, N., Radhakrishnan, A., Bajwa, R., Manyam, H., Post, J. C. (2010). An electronic hand hygiene surveillance device: a pilot study exploring surrogate markers for hand hygiene compliance. Infection Control Hospital Epidemiology, 31(06), 634-639. Twigg, D., Duffield, C. and Evans, G. (2013). The critical role of nurses to the successful implementation of the National Safety and Quality Health Service Standards. Australian Health Review, 37(4), p.541. van de Mortel, T. F., Apostolopoulou, E., Petrikkos, G. (2010). A comparison of the hand hygiene knowledge, beliefs, and practices of Greeknursing and medical students. American journal of infection control, 38(1), 75-77. White, K. M., Starfelt, L. C., Jimmieson, N. L., Campbell, M., Graves, N., Barnett, A. G., ... Brain, D. (2015). Understanding the determinants of Australian hospital nurses hand hygiene decisions following the implementation of a national hand hygiene initiative. Health education research, 30(6), 959-970. World Health Organization. (2010). WHO guidelines on hand hygiene in health care: first global patient safety challenge. Clean care is safer care. World Health Organization.