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Hand Washing Policies

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Policies and Procedures: Hand Washing

Every healthcare institution has to follow certain policies and procedures in order to ensure best patient outcome. Nurses follow procedures on the floor that institutional policies are put into practice. It is necessary that the policies and procedures drafted must be something that is clear, can be measured and enforced that it helps practitioner to understand the importance and effectiveness of the policy (Ray, 2011) , In this paper, I would like to detail the basic but the most important hospital policy; hand washing.
In the united States, one every 136 patients visiting or admitted in hospital become seriously ill due to hospital acquired infections which equals two million cases a year (Joint Commission, 2011). Based on the research evidence, our hospital has hand washing policy implemented strictly that number of hospital acquired infections can be brought down with proper hand hygiene. The policy applies to all nurses, physicians, students, visitors and all healthcare professionals in the hospital settings.
Hospital is a place where various patients with low immunity and different infections meet. It is the place where high chances of cross contamination and hospital acquired infections exist, resulting in high cost of care and numerous deaths. Importance of hand washing in reducing nosocomial or hospital acquired infections has been well described and advantages emphasized in various research studies. Unfortunately, the compliance with the same procedure on nursing floor is not optimal, mostly due to low staff distribution per patient, inaccessibility to the equipment, product allergies, lack of time to follow the procedure properly and the high recommended time for the procedure (WHO, 2002). Depending on the risk for infection, hand washing technique also varies. Minimal hand washing with soap and water is used at places with minimum risk for infection while some sort of antiseptics is used where medium risk of infection exists. For surgical procedures where high risk of infections exists, major antiseptics are required for cleaning and hand hygiene.
As a child I remember going to school and eating everything that was offered to me without even looking into how safe it was. I have also witnessed my classmates having stomach ache, vomiting and getting infected with many diseases and hospitalized only because they would never wash their hands before eating or after using restrooms. I had no knowledge that time the importance of hygiene and how many of those problems could have been avoided just by washing hands! Later, when I became a nurse and started practicing on the floor, I realized how important it was. Even though hand washing is the most important aspect of care on the floor, often I am surprised at the negligence of many healthcare professional not following the procedure the way they should. When questioned, many of them have the explanation that they had not enough time. We often do not realize how a change of gloves or washing hands couple of times between care and during change of patients have saved millions in care and avoided prolonged hospitalization. I have also witnessed poor patient outcome and long time hospitalization of patients just because some nurses would not follow the procedure the way they should.
One day, I saw a nurse change dressings on a seriously infected patient, without washing hands or wearing gloves. I did not interrupt her during the procedure but once the dressing was finished, I took her to the nursing station and asked her whether he got any children. She told me that she had a four year and one year old. I asked her whether she would mind her kids get infected with some of the antibiotic resistant organisms. She stared at me. I explained to her what a serious breach of policy and harm to herself has been done just a few minutes before. If she goes home and follow the same rules at home, serving her kids without washing hands properly, she would be acting as a carrier taking all those lethal organisms home and distributing it to her children and family. It would also harm her personally and expose her to many of the unidentified diseases from the patients. She also harmed the patient who trusted her and visited the hospital with a hope of recovery. She regretted her action and I was glad to watch her following all he procedures to its minute details later.
We will be shocked while reading through the Center for Disease Control(CDC) report about the death toll of around ninety thousand (90,000) people every year due to hospital acquired or nosocomial infections (CDC, 2010). All throughout our nursing course and practical, we were thoroughly instructed about the importance of hand hygiene. We are also given to understand the various diseases and cross contamination and poor patient outcomes that are mostly the results of poor hygienic practices or not following proper aseptic techniques, especially hand washing. Streptococcal and Staphylococcal infections the most common that patients acquire from the hospital floor. Danger or antibiotic resistant organisms and patients dying without an effect from the medications are a nightmare of every institution. Unit where I work and other units in our institution have printed posters on every room of the floor about the importance of hand washing.
As a senior RN working on the acute care unit or while working for geriatric clients in the rehab unit or nursing home, I realize my obligation towards the public to instruct and report the repeated violators, as I place patient safety before anything else. Saving life is my duty and obligation and I am obliged to do so even if it runs against the interest of someone. We have been taught the happy birthday song during hand washing classes. Thirty seconds time required to properly wash hand and using the foam sanitizer every time we enter or exit the patient room needs to be adhered for the sake of the people who trust themselves to us for care and safety. During my career, I have noticed some staff frequently overriding the policy and violating the procedure. I have tried times and again to tell them in private how this could be fatal to the patients we care. Some of them have shown animosity but I have noticed with satisfaction when most of them following it finally.
Hospital administration and RNs should adopt an evidence based design and approach while taking care of the patients in the acute and critical care settings. It is the responsibility of the staff and administration to assess regularly the chances of infection and take protective measures to prevent infections and cross contamination in order to make hospital a safe place for patients to treat and recover. For this, all aseptic techniques should be strictly enforced. Educating staff and visitors frequently through posters and pamphlets as well as making the materials for hand washing handy, with proper instructions for its use and advantage are important.
In conclusion, every health care professional in the facility is responsible to make hospital a safe place for patients. Administrators must draft precise, easy to understand policies, enforce procedures and at the same assess the results of the implementation. It is the duty of every health care professional to follow the hand washing procedure with utmost care and at the same time keep educating visitors and patients about proper hand hygiene procedures as part of the preventive care envisaged by the present health care system. That way, we bring the entire society to the fold of health care worker and reduce infections and diseases in the population to a great extent.

References
CDC. (2010). Hand washing: Hand Hygiene in healthcare Settings-Core. Retrieved Feb 16, 2013, from http://www.cdc.gov/HandHygiene/download/hand_hygiene_core.pdf
World Health Organization (2002). Prevention of Hospital Acquired Infections. Retrieved from http://www.who.int/csr/resources/publications/whocdscsreph200212.pdf
Ray, Linda. (2011). How to Write Nursing Policies & Procedures. Retrieved on February 10,
2013, from http:/ / www.ehow.com/ Web site: http:/ / www.ehow.com/ how_5009640_write-nursing-policies-procedures.html
Joint Commission Center for Transforming Health Care. (2011). Why Hand Hygiene? Retrieved on February 15, 2013 from http://www.centerfortransforminghealthcare.org/assets/ 4/6/hand_hygiene_story_board.pdf

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