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What is the extent of non-compliance with handwashing protocol among health care workers during routine care for breast reconstruction patients who have had mastectomies?
P – Health care workers who wash their hands during routine care for breast reconstruction patients who have had mastectomies
I – Handwashing
C – Health care workers who do not comply with handwashing protocols
O – Observation of compliance with handwashing protocol
The researcher, who is a director of nursing at a surgery center, observed that some of the patients lost their reconstructed breasts because of poor hand hygiene among health care providers during their routine care to patients. The major aim of the hand-washing project is to identify non-compliance with handwashing protocols among health care workers. The researcher noted that increased compliance with the handwashing protocol could prevent MRSA (Methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant enterococci), and other hospital-associated infections (HAIs) among breast reconstruction patients who have had mastectomies. Trained unidentified observers would carefully monitor current compliance with handwashing protocols among health care workers. Current research has demonstrated that the presence of hospital-associated infections (HAIs), which have presented significant risks to patient health is related to high rates of mortality that ranged between 5% and 35% (Flodgren et al., 2013). In addition, they also accounted for patient morbidity in the intensive care unit (ICU).
Studies have noted that hand washing is a critical routine procedure in health care settings to prevent the spread of hospital-associated infections caused by MRSA, VRE, and other pathogens (Samuel, Almedom, Hagos, Albin, & Mutungi, 2005). Closer attention, therefore, to such a simple, basic hygiene procedure could be a method of reducing hospital-associated infections and costs of health care provisions. Since the time of Semmelweis (the pioneer of handwashing in the 1840s), hand hygiene has proved to be effective in eliminating cases of nosocomial infections among patients in ICUs and emergency departments (Samuel et al., 2005). Noncompliance with handwashing was however common among health care (Pittet, Mourouga, & Perneger, 1999).
Just like in the past, the adoption of simple, effective, and affordable protocols of handwashing has continued to demonstrate poor responses and gradual progress because of poor human behaviors related to ignorance, attitudes, carelessness, or arrogance among health care providers irrespective of their levels of skills, knowledge and academic qualifications. Usually, various health care stakeholders have provided, updated, and improved hand hygiene guidelines and protocols regularly. Moreover, there is constant education, technical training on hand washing, the best approaches, and incentives for health care providers to adopt and observe hand hygiene (Hartocollis, 2013), yet a matter of handwashing continues to present one major obstacle to health care workers.
Various studies have highlighted diverse reasons for poor compliance with hand hygiene guidelines among health care workers, which included “dry skin, the pressures of an emergency environment, the tedium of hand washing and resistance to authority (physicians, who have the most authority, tend to be the most resistant, studies have found)” (Hartocollis, 2013). While other studies have demonstrated bad human behaviors, others have noted a lack of scientific knowledge and awareness as major contributors to poor compliance with hand hygiene guidelines (Mani, Shubangi, & Saini, 2010).
Ineffective observation and compliance with hand hygiene guidelines have, therefore, resulted in the high number of morbidity and mortality (Flodgren et al., 2013) in addition to high medical costs.
References
Flodgren, G., Conterno, O., Mayhew, A., Omar, O., Pereira, R., & Shepperd, S. (2013). Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database System Review, 3, CD006559. Web.
Hartocollis, A. (2013, May 29). With Money at Risk, Hospitals Push Staff to Wash Hands. The New York Times. Web.
Mani, A., Shubangi, A.M., & Saini, R. (2010). Hand hygiene among healthcare workers. Indian Journal of Dental Research, 21(1), 115-118.
Pittet, D., Mourouga, P., & Perneger, T. V. (1999). Compliance with handwashing in a teaching hospital. Infection Control Program. Annal of Internal Medicine, 130(2), 126-30.
Samuel, R., Almedom, A., Hagos, G., Albin, S., & Mutungi, A. (2005). Promotion of handwashing as a measure of quality of care and prevention of hospital- acquired infections in Eritrea: The Keren study. African Health Sciences, 5(1), 4– 13.
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