The Crucial Role of Hand Hygiene in Preventing Infections


The process of handwashing is an essential part of the daily routine of life. It is also important to prevent the infectious spread and thus to help in preventing illness (Staats, 2017). It also further helps in preventing the spread of various communicable diseases from one patient to another. The practice of good hand hygiene will help prevent diseases like ordinary flu, food poisoning and even hospital-acquired infections. Non-compliance with hand hygiene is one of the leading causes of the spread of hospital-acquired infection in a healthcare setting (Vermeil, 2019). Therefore, the inclusion of a good hand hygiene practice can play a vital role in potentially decreasing the spread of these types of infections from one patient to another. If nurses follow the practice of hand hygiene, they can prevent themselves from catching an infection and help contain the spread to the patient as they are the front line workers of the patient care process. However, young nurses might lack the education required to follow strict hand hygiene guidelines and protocols, including handwashing in their daily routine (Ahmed et al. 2020). Therefore, educational strategies are required to help these young nurses to have a good idea of the importance of hand hygiene in nursing practice (Lydon, 2017).


This assignment will present a discussion on how adult nurses can be advised and guided in following and implementing the necessary strategies of hand hygiene in their practice to maintain proper healthcare hygiene as well as to avoid the risk of spreading communicable diseases. In this context, this assignment will first use the PIO tool for formulating the relevant research question regarding the selected research topic. Then this assignment will discuss the research methodology by discussing the search strategy, keywords and Boolean operators that are used to collect the relevant research articles on the selected research topic. Then the assignment will present the critical analysis and discussion, in which the database that is retrieved from the select research article will be compared and analyzed to answer the research question and meet the research objectives. Finally, this assignment will present a conclusion in which the main aspects of their research project will be discussed.

Literature search:

PIO [problem, intervention outcome] framework is widely used in academic research to formulate well-focused research questions on the research topic (Etikan et al. 2016). Here researcher used PIO tools for forming the highly appropriate and well-constructed research questions by analyzing the three major aspects such as patients, the clinical intervention of maintaining proper hand hygiene by nurses and the outcomes of hand hygiene. By using the PIO tool following research question is formed:

"What is the role of education in nurses to educate about hand hygiene compliance and improve patient safety?"

PIO Framework

PIO Framework

Search strategy:

A search strategy is the crucial aspect of any academic research, that enables the researcher to collect the relevant and authentic database on the selected research topic to meet the research objectives (Thielen et al. 2016). In this research, the project researcher conducted secondary research by collecting and retrieving the appropriate and relevant online research articles on the research topic. the researcher used relevant online databases such as CINAHL, PubMed, Psych Info, British national Index, MEDLINE, google scholar and Cochrane in terms of searching for the relevant research articles (Rahi, 2017). While searching for these research papers, it was seen that the search result obtained by using BNI had several duplicated research papers therefore the search results by using BNI had been removed. keywords and Boolean operators (OR, AND, NOT) are used to expand or narrow the literature search thereby collecting the relevant research articles in the selected research topic (Palinkas et al. 2015).

Keywords:0 Keywords:1

Inclusion and exclusion criteria:

Inclusion and exclusion criteria are the predefined characteristics that are used to select research papers that are highly authentic and relevant to the selected research topic. here researcher used the following conclusion and exclusion criteria:

exclusion criteria:1 exclusion criteria:2 exclusion criteria:3

With the help of a methodical and step-wise approach, relevant studies relating to the keywords and the focus question were extracted for the analysis purpose. Another commonly used Boolean operator was considered for this analysis. This was done with the help of the use of the "AND" operator (Kruse, 2017). This helped in connecting two words and inserting them in the same search category. This helped in narrowing down the search. This was fruitful in connecting some of the important terms such as "nursing professionals", "healthcare professionals", "education strategies", "educational interventions", "improved clinical management", "improved clinical outcomes", "adherence", "and compliance" and so on. It was also focused that all articles that were considered for the analysis were in the English language. This was done as per academic integrity standards (Long et al. 2020.). All of the studies which were published between the year range of 2015-2021 were considered for the evaluation purpose (Javadi and Zarea, 2016). It was also made sure that all of the articles were peer-reviewed.

Selection of literature

Multiple resonating records were analyzed, and approximately 100 articles were considered after the primary search. From these studies, an additional number of about 80 duplicate records were removed. The remaining 20 articles were judged based on the abstract of the study. This helped in checking the articles for meeting the inclusion and exclusion criteria for the evaluation. [refers to Prisma diagram in appendix1]

Further filter was applied to select all of the full-text articles so that meta-analysis of the details can be scanned thoroughly. Out of these defined results, the articles based on qualitative and quantitative research method approaches were further bifurcated. The two studies from each category were considered based on inclusion criteria. The selected quantitative research was Trannin, K.P.P., Campanharo, C.R.V., Lopes, M.C.B.T., Okuno, M.F.P. and Batista, R.E.A., (2016). Adherence to hand hygiene: intervention and assessment, and the selected qualitative research study were Kaur, R., Razee, H. and Seale, H. (2016) 'Development and appraisal of a hand hygiene teaching approach for medical students: a qualitative study, Journal of Infection Prevention. These two studies met with the defined specification and the main framework of the focused question.

Critique of the qualitative study:

The C.A.S.P. tool is one of the most effective critical appraisal tools of any research study (Long, 2020). Therefore, this tool was applied to appraise the selected research studies critically. The CASP tool or the critical appraisal skill program tool is a highly useful technique the enables researcher to evaluate the strength and limitations of selected qualitative literature.

The critique; Kaur, R., Razee, H. and Seale, H. (2016) 'Development and appraisal of a hand hygiene teaching approach for medical students: a qualitative study, Journal of Infection Prevention.

This research study aims to evaluate the teaching module in improving the conception and knowledge of the medical student on Hand Hygiene (HH). Here 24 medical students were interviewed in groups to receive their feedback regarding the usefulness of the scenario-based learning activity. The findings from this research study are highly beneficial and important in the current healthcare context to draw the attention of the higher healthcare officials regarding how to improves the training and learning on HH for improving the ability of the medical student to comply with HH policies. This study is also important in providing the evidence base information to the modern medical professional to use and implement effective changes in the conventional teaching and learning process to improve the process of educating the medical students regarding maintain proper HH into the practices. On the contrary, Staats et al. (2017) argued that competence with the HH policy by medical students is not only based on the education and learning process but also on the teaching skill of the teachers, the intelligence of the student and the teaching faculties and infrastructures in the medical schools. Acceding to Vermeil et al. (2019), how efficiently students will comply with all the HH policies is entirely dependent on how perfectly they are trained and taught regarding this topic in medical school. the author also stated that medical schools must have a modern teaching infrastructure that will enable the teaching staff to implement the innovative teaching and learning framework to ensure the medical student can easily develop the ability to comply with the HH policies (Hadaway, 2020).

The finding from the research study done by Kaur et al. (2016) can be applied in the modern medical field in terms of guiding the teachers and lecturers in medical schools to use innovative teaching and learning techniques to improve the skill of medical students about how to maintain proper HH into practices. Moreover, this study is also applied to improve the knowledge and understanding of medical students regarding communicable diseases and their ways of spreading (Ahmed et al. 2020). this research study presented an evidence-based information regarding how the medical student can comply with all the HH policies to prevent them causing and spreading of HAI (healthcare-associated infection), thereby promoting the policies health and wellbeing of clients.

A review of Trannin, K.P.P., Campanharo, C.R.V., Lopes, M.C.B.T., Okuno, M.F.P. and Batista, R.E.A., (2016). Adherence to hand hygiene: intervention and assessment.

Trannin et al. (2016) mentioned in their research study regarding the use the effective education to medical students to improve the understanding of how to adhere to HH policy. This research study is highly useful in modern clinical practices, which will enable the nursing students to obtain a good understanding and concept of HH policies and the process of implementing these HH policies into practices to ensure safe care to patients (Trannin et al. 2016). this research study is also useful in guiding the modern nursing student regarding how to use HH policies to avoid the risk of different Healthcare-associated infections into practice (Alshammari et al. 2018).

as argued by Saitoh et al. (2020), while it comes to discuss the importance of education to medical students to improve their knowledge on HH, it is important to discuss the also the limitations of this education the major limitations of modern education regarding HH is it more practical based and less theoretical based which makes it difficult for the medical staffs to gain the theoretical in-depth understanding on HH (Ridley, 2020). Another limitation is the lack of skilled teachers and conventional educational framework which pose poor emphasis on providing a well-organized knowledge on HH to nursing students.

Trannin et al. (2016) highlighted the prevalence of hospital-acquired infections as one of the most vital sources of infection. This study is highly applicable in the current medical context as it assists medical professionals to know how this issue directly compromises the patient's safety and health issues (Villarreal et al. 2020). Therefore, fulfilling the importance of hand hygiene adherence in a clinical healthcare setting. The study design on which the study was based included an explanatory research design. This type of study design helps focus on the required information and narrow down the intentional bias with the results and the study design (Rahi, 2017). It is also valuable for providing exploration of variables in a detailed manner. Thus, helping in connecting the missing dots of the study inclusions. This design will also help highlight the factors which might influence the adherence or non-adherence in participants of the study design. The study design was able to connect with the main aims and objectives defined for the study. The use of this method is also helpful in getting a generalized finding for the study subject. This type of study design also helps in reducing the complexity of the subject and defining results in a more controllable manner (Bloomfield, 2019). Thus, this study design is most apt for this subject of choice. The study did not include any direct participants. However, the results were based on an analysis of a pattern of adherence to hand hygiene in nurse practitioners and physical therapists.

The recruitment of instead data was based upon an observational analysis. However, this step of recruitment fulfilled the criteria for meeting the set standards of aims and objectives of the study. Data were collected with the help of a convenience sampling method. This type of sampling can be most effective to promote the ease of research. The data can be collected for any population group with this method of sampling (Etikan, 2016). It is also a relatively cost-effective and robust method for collecting abstract data. As the study was based on evaluating a pattern of hand hygiene adherence, this sampling method can be the best possible and flexible choice for data collection. The collection of data was also bifurcated into pre and post-intervention periods. This helped in enabling a comparative analysis of the results obtained from the study.


Trannin et al. (2016) aim to discuss the importance of adherence to the HH in preventing the risk of healthcare-associated infection (HCAI) in emergency care. As mentioned by Saitoh et al. (2020), all healthcare professionals must have a good understanding of all the HH policies that they need to comply with while working in the emergency ward. According to Villarreal et al. (2020), adherence to HH is crucial for the healthcare professional not only to prevent the risk of HACI but also to promote the positives health and wellbeing of the healthcare providers as a healthcare users. The study was based on examining hand hygiene practice in the emergency department, which can be considered a potential source of infectious spread (Trannin, 2016). The study also highlighted the adherence and continuation of educational strategies for promoting hand hygiene practice in a healthcare setting. However, the study's main limitation was not highlighting the data on the technique of hand hygiene used by healthcare workers in the emergency department.

The research study done by Trannin et al. (2016) is highly useful in guiding the senior healthcare professionals regarding what changes or modifications need to be implemented into the conventional teaching ad education process in the medical school to ensure the medical students can easily learn how to compliance with HH policy into practices. Additionally, the study is highly relevant to the context of maintaining proper HH into clinical practices, to develop a clear conception in medical students of all the statutory guidelines of HH.

On the contrary Saitoh et al. (2020) argued that, in case of maintaining proper HH, medical students must ensure that all the healthcare professionals must work in collaboration to maintain a shared decision making regarding what strategic need to b be used to improve the HH framework. Trannin et al. (2016) however do not discuss how the shared decision making can be implemented in modernizing and improving the overall HH framework. On the contrary, Ridley (2020) argued that, while educating the medical staff, the medical teachers must consider the factors that can interfere with the outcomes of the education to the medical students on HH. These factors are the knowledge of the teachers regarding the modern HH policies in healthcare, the availability of educational resources, the viability of highly experienced and highly skilled teachers in medical schools and healthy relationship between students and teachers.

On the other hand, the study conducted by Kaur et al. (2016) helped highlight upon drawing the focus of medical students towards hand hygiene practice. The study helped in gaining favourable feedbacks from the analysis. The study was also able to focus importance on the suggestion of inclusion of activities for potentially increasing the knowledge of hand hygiene in medical students (Kaur, 2016). It was also able to show how these strategies could reduce the incidences of infectious spread in healthcare settings. The main limitation of this study was observed in terms of restriction of data collected from only one potential source. The study was based on an analysis of medical students from a single medical school. Thus, restricting the researcher to explore the pattern of non-adherence to hand hygiene in a healthcare setting. The study also failed to check with the medical students for their respective knowledge of the subject matter and their respective approaches towards hand hygiene practice. The study also reflected on the overall challenge of engaging medical students in the robust practice of hand hygiene and encouraging them for educational strategies.

Overall, the quantitative study results showed a positive inclination of nurses towards hand hygiene after getting proper educational interventions. The adherence towards hand hygiene was also found to have been improved in these subjects. However, the qualitative study highlighted the importance of the topic of hand hygiene and how this subject is quite underestimated. Therefore, there is a higher need to better approach various educational strategies to fill these educational gaps. The same will help improve the reduced incidence of infectious spread. Therefore, helping to improve patient safety and enabling improved healthcare outcomes for the patients.

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From the above-mentioned discussion, it can be concluded that Hand Hygiene (HH) is crucial in healthcare to promote the positive health and wellbeing of services providers and service users. Education to medical staff on how to maintain proper HH practices is important which will not only enable them to avoid the risk of any healthcare-associated infection during the professional practices but also maintain a high level of patient’s safety. Through educating medical students regarding HH, it is possible to improve their conception regarding the policies and practices of HH. Additionally, through using the modern teaching adhering techniques, medical staff can be educated easily regarding how to comply with all the HH policies to maintain workplace safety and hygiene. This education to medical staff will also improve their understanding regarding the factors that can interfere with the ability of healthcare professionals to comply with the HH policies such as the skill of medical staff in complying with HH, the cooperation from healthcare used in maintaining HH, the knowledge of medical staffs regarding the process of maintaining HH and the infrastructure in healthcare workplace to maintain proper HH.


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