Hand Washing

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In 1847 Ignaz Semmelweiss discovered that healthcare associated infections (HCAIs) were commonly transmitted by the hands of healthcare workers and hand washing was an important component in breaking the chain of infection (Weston, 2008 and World Health Organization (WHO), 2009). Hand washing helps to control infection rates (Weston, 2008) and is the simplest and most effective way to break the chain of infection and prevent HCAIs (Pittet & Boye, 2001). This assignment will examine the chain of infection, how infection is spread and the subsequent consequences. The process of hand washing will also be explored, looking at when hand washing should be used, technique and whether when used alone it is enough to break the chain. Ignaz Semmelweiss also discovered that there were significant barriers to hand washing (Weston, 2008), these will be discussed and some solutions will be considered. The Nursing and Midwifery Council (NMC) Code of Conduct (2008) states that you must identify and minimise any risk to patients, placing a duty on healthcare workers, this is supported by The Health and Safety at Work Act (1974). The Health and Social Care Act (2008) and The Health Act (2006) also protect patients by setting out legal guidelines and requirement for care providers and acute hospitals regarding hand hygiene. HCAIs cost the NHS approximately one billion pounds each year (Cookson et al., 2001) and can increase patient’s stay in hospital (Pittet et al, 2011). MRSA can be an extra ten days, CDIF up to an extra twenty one days costing between four and ten thousand pounds more to treat a patient (Pittet et al 2011). For the he patient HCAIs mean an extended stay in hospital, unnecessary pain and discomfort and costs resulting from time off work, child or pet care. HCAIs affect approximately 300, 000 patients each year in the UK and bacterial infections are becoming increasingly difficult to fight (Pittet et al., 2011), HCAIs include Vancomycin- resistant Enterococcus (VRE), Norovirus, Gastroenteritis, Methicillin-resistant Staphylococcus aureus (MRSA) Clostridium difficile infection (CDIF) (Brooker et al, 2000). HCAI prevalence in hospitals in England is 8.19%, a figure that could be significantly reduced (Davies et al., 2006). Hand washing is the leading prevention method and the minimum patients expect from healthcare workers (Pittet et al, 2011). Hand washing also helps reduce costs, morbidity and mortality (Motacki, & Kapoian, 2011). The chain of infection is the spread of infection from one individual to another (Weston, 2008). It starts with the organism; bacteria, virus, fungi, and parasites. Pathogens are carried in blood, excretions, secretions, skin scales, vomit, food, water and other bodily fluids (Motacki & Kapoian, 2011). Transmission from the source can happen through inhalation, indirect or direct contact or by arthropods (Rogers & William, 2011). The next part in the chain is the reservoir or breeding ground; the hands are an ideal place for bacteria to colonise (Ayliffe et al., 2000). All humans have resident flora, not likely to cause infection and transient flora which can colonize and multiply on the superficial layers of the hands. It is the transient bacteria that may be pathogenic (Brooker et al., 2000) and contains two types of proteins that cause infection, exotoxins and endotoxins that cause fevers and do not respond to antibiotics (Rogers & William, 2011). Health workers need to be aware that everyday patient care activities that require direct contact can spread infection (Motacki & Kapoian, 2011). Transport via hands is the link in the chain that can be broken (Pittet, 2000). The next stage in the chain of infection is the portal of entry; pathogens can enter the body through the GI tract, respiratory tract or skin (Weston, 2008). According to Emmerson et al. (1996) the most common types of infection are on the skin, surgical sites, the urinary tract and the lower respiratory...
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