In hospitalized patients (P), what is the effect of hand washing (I) on infection control (O) compared to hand sanitizers (C), over a 3-month-period(T)?

Title: The Literature Reviews Hand Washing versus Sanitizing Hospitalized Patients for Infection Control

Abstract: Hospital-acquired infection is a serious problem. It can lead to increased patient morbidity and mortality as well as higher healthcare costs. The primary way to reduce the spread of hospital-acquired infection is hand hygiene. This article reviews literature to determine which handwashes are more effective than hand sanitizers in infection control for hospitalized patients. The background, significance, purpose, selection methods and results from four independent research studies are all discussed in this paper. These key points will be summarized and discussed along with the implications for nursing practice. Keywords for this article: infection control, hand hygiene, hand washing.

The significance and background of hospital-acquired infection (HAIs). These infections can lead to increased morbidity and mortality as well as higher healthcare costs. According to the World Health Organization, 7% of patients admitted to hospitals in developed countries will contract an HAI. The percentage in developing countries is higher (WHO 2019, 2019). The HAIs lead to longer hospital stays and more readmissions. They also result in higher healthcare costs. Bloodstream infections and infections of the urinary tract are three most frequent HAIs. The primary way to reduce the spread of HAIs is through hand hygiene. Hand hygiene is a key factor in the prevention of HAIs. Healthcare workers (HCWs), perform hand hygiene prior and after patients contact and use personal protective equipment (PPE) if necessary. Even though there are ample data supporting hand hygiene’s importance, healthcare workers still struggle to comply with the guidelines.

Scope: This paper will review literature about the effectiveness and safety of hand washing in preventing infection among hospitalized patients. This paper will address the issue of HAIs in healthcare, how hand hygiene can be used to prevent infection, as well as what we know about the situation in non-USA countries. This paper will review four research papers that have been published in peer reviewed nursing journals. Nursing practice in non-USA countries is at least one of the research studies.

Methods: Research studies were found through systematic searches of CINAHL and PubMed electronic databases. The search terms used were “hand hygiene,” “hand washing,” “hand sanitizers,” “infection control,” “hospital-acquired infections,” “healthcare workers,” and “hospitalized patients.” The inclusion criteria were: (a) original research studies published in peer-reviewed journals between 2014 and 2023, (b) studies comparing hand washing to hand sanitizers for infection control in hospitalized patients, (c) studies conducted in the USA or a non-USA country, and (d) studies with a sample size of at least 50 participants.

Study 1: Nursing Research Study in America: A single nursing research study was conducted in America and it was evaluated. Chen and colleagues. (2018) examined the impact of hand hygiene education on the reduction of HAIs at a hospital-based ICU. It used an experimental design that included a control group as well as an intervention group. Results showed that HAIs were significantly less common in the intervention than the control group. According to the authors, hand hygiene education and the use alcohol-based hand sanitizers are effective strategies for decreasing HAIs within the ICU.

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