If you Simply Don’t have Time

“Although the regular use of hygienic soap and water hand-washing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the hand-washing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.” (Zaragoza, Sallés,  Gomez,  Bayas & Trilla, 1999)

The question that arises with hand-washing is alcohol an “ok” second best solution? The answer is YES! Hand-Washing will always be the best solution and in most ideal situations will be the preventive disease measure taken regularly,  but sometimes “we” as nurses just don’t have time.

A real life example:

I was at my Nursing Externship yesterday (June 6, 2012) and my nurse and I had 5 patients who were all on medications at certain times, one had  a blood transfusion going, another had constant pain around the clock that needed to be monitored, one patient needed assistance every time they wanted to get up, and then to top it off the last one kept getting sick. As you can see my day was packed, and then mid-afternoon one of the nurses on the floor had a family emergency and had to leave, so we then got two more patients to help cover the floor. I was running around that hospital floor like a” mad-women.”  Every patient needed something different, at a different time and on opposite sides of the floor.  It was one of the days where I just didn’t feel like I had time.

…And this is where the second best solution comes in. Even if you’re not a nurse like myself and maybe you are a school teacher, a chef, a police officer, or a sales clerk. It’s still important to be performing some type  of disease preventing measure to help keep people healthy from the spread of germs.  Raka (2010) came up with the solution, “Hand hygiene remains the simplest and the primary measure to prevent Hospital Acquired Infections and reduce spread of multi-drug resistant organisms. Although hand hygiene is a simple measure, the lack of compliance among healthcare workers is problematic worldwide, averaging <40%.  In 2002, the CDC recommended the use of alcoholic hand rubs which have the advantage that they can be placed at the bedside. Also, where hand-washing facilities are primitive or scarce, it is often easier to provide a hand rub than sinks with running water and a functioning sewage system. Introduction of alcohol- based hand rub has led to increased hand hygiene compliance among healthcare workers and fewer Hospital Acquired Infections.”

You should always try and make time to wash your hands, but sometimes second best will have to win because the most important thing is staying healthy and stopping the spread of germs.

References:

Raka, L. (2010). Prevention and Control of Hospital-Related Infections in Low and Middle Income Countries. Open Infectious Diseases Journal, 125-131.

Zaragoza, M., Sallés, M., Gomez, J., Bayas, J., & Trilla, A. (1999, July). Handwashing with soap or alcoholic solutions? a randomized clinical trial of its effectiveness. . Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

 

Hand-Washing Reminders, Are they Helpful or a Nescience?



Everyone has seen simple Hand-Washing reminders in local bathrooms, restaurants, hospitals, and maybe even at your own work. But are these helpful reminders or a nescience? Many studies have been done to see if these signs have been deemed effective. In a study done in 2008, Press &Journal discovered that it is a success! The site that they chose to use as a subject used the method of, “Anyone who walked in or out of a ward activated a battery-powered unit that issued a gentle reminder to wash their hands.” (Press & Journal, 2008) After these signs were posted throughout the hospitals, more doctors and nurses remembered to wash their hands as well as the mode of transportation for bacteria was decreased.

So many germs and diseases float around on hospital floors and it’s important to protect our patients as well as the nursing staff. Press &Journal (2008) stated, “Good hand hygiene is recognized as the key to reducing hospital-acquired infections such as diarrhea and vomiting, and more serious germs such as MRSA.” In other studies done through other hospitals with similar outbreaks concluded, “Due to recent outbreaks of norovirus in hospitals across Wales, the Carmarthen hospital has implemented a strict hand-hygiene policy to help prevent staff and patients becoming infected with the virus.” (Sinclair, 2009) Both of these studies confirmed that strict hand-washing was applied to that unit and less bacteria was spread like MRSA and norovirus and decreased hospital acquired infections.

As you can see in these two studies, all hospital  encounter the same problems of outbreaks with different strands of bacteria, but the helpful reminders to wash your hands was deemed to be a success. Sometimes we as nurses are running around the floor trying to make sure that everyone is comfortable and helpful reminders can be enforcements to make sure we are killing germs between patients’ rooms as well as infecting ourselves.

(2008, March 8). Hand-washing reminder is a success at hospital. Press & Journal, The (Aberdeen). p. 4.

Sinclair, B. (2009, January 7). Hospital highlights hygiene. Carmarthen Journal Series. p. 31.

 

 

 

Why does it seem that nurses don’t have time to wash their hands thoroughly?

I am currently in my Externship at Henrico Hospital on the General Surgery floor, and I want to take you through a typical nurse’s day from the nurse’s point of view. I hopefully can help pin point where the hand washing is needed most and why it seems that nurses don’t have time to wash their hands thoroughly.

645am Nurses arrive to the floor

700am Change of shift report from the night nurses.

730am Meet the patients

800am The “Chaotic-ness” begins.

Most typical nurses have around 4 patients on a 12 hour shift. These patients can vary in different cases and reasons why they are in the hospital. The patients that I have had most recently ranged from having cancer, gastric bypass with a hernia, Heart Failure, and an Abscess with a drain. And I know most people don’t know medical terms or what any of these diagnosis’s are, so I will narrow them down for you by saying all these patients need vital signs every 4 hours, most medications every 4 hours, showering, bathroom breaks, drains emptied, food trays, more medications, more vital signs, bathroom breaks, something to drink, and the list goes on. As you can see this list can be repetitive at times and no patient is on the same schedule. So if one patient gets medications and vital signs at 8am, then another patient is on an entire different schedule and gets them at 9am. On top of all of this, you have to chart everything that you do for that patient, all medications, and assessments that you make on that patient, and each patient has their own separate chart.
When it comes to 12 hour shifts for nurses, you are constantly moving and doing things for the patients. Doult (2011) confirms, “I have spoken to nurses in the past few days who say they have never felt so much pressure in their day-to-day work as they are feeling right now.” I know sometimes it may look like the nurses are just sitting at the desk and being lazy, but I promise that isn’t even half of the story. Most mornings I don’t even get to use the bathroom till 4 hours after my shift has begun because I am too busy trying to make sure all things are done at the right time and that all patients are comfortable.

What it comes down to is that nurses have quite an extensive list of things to do in their shift and sometimes washing hands doesn’t always seem like the highest priority. But when you’re in and out of patients rooms multiple times in a hour and going from other patients rooms who may have an entirely different diagnosis and disease, then you don’t want to add to someone else’s problems. And if that is not enough of a convincing argument then look at it from your own health, and you go into a patient’s room to help them use the bathroom and you don’t wash your hands or wear gloves and then 5 minutes later you go to lunch and have chicken fingers. Germs spread and we have to kill them at the sources. I know coming from a nurse’s perspective that yes we are busy through-out the day with all the tasks that must be done, but washing hands is still vital. I do believe that hand sanitizer is a step forward then what it used to be before invented and that it does kill a good percentage of germs. Sometimes as the nurse it may be the only thing you can do between one patient’s room to the next because of certain situations and time crunches but to make sure you always make time in the end to protect others and yourself.

 

Citation:

Doult, B. (2011). Nurses have never felt so much pressure in their day-to-day work’. Nursing Standard26(5), 11.

 

Your Health is in Your Hands

There have been many hypothesized solutions to try and prevent the spread of germs and bacteria throughout hospitals.

  • Hand Sanitizers have been placed in every room as well as in the hallways.
  • Gloves are required to be worn when coming in contact with patients.
  • Each patient will get their own supplies and if it enters their room and it was not used, it still must be thrown away.
  • Nurses/Doctors should wash their hands when entering a room and when leaving a room. Most doctors including Issa Bascom (2007) have the philosophy of, “If they come in, they wash and sanitize before they touch anything.”

Even after all of these changes have been put into place to help prevent the spread of germs, hand washing is still the number one way to prevent it. Poster (2004) confirms that, “Hand washing is your No. 1 anti-infection control.” The problem in today’s hospitals are that health workers know the effect hand washing has and some people choose to follow these protocols while others still choose to ignore it. An example of this took place when I was working at a local agency called the Woodlands in Farmville. There was this bacterium called C.Diff going around from patient to patient and they couldn’t figure out how so many patients where getting it. Then one day we watched a nurse go from one patient’s room all the way down the hallway to another patient’s room with only washing her hands with sanitizer. Two days later that patient down the hallway developed C.Diff and we then knew that we had just witnessed the spread of germs. Needless to say more protocols were set into place after the incident, but the damage had already been done. What if it had been a life threatening disease and the nurse then harmed two patients.

 

Citations:

 

Aleccia, J. (2007, September 18). Urging hands-on hygiene: Program finds better sanitation when patients remind caregivers to wash up. Spokesman-Review, The (Spolana, WA).

 

Poster, E. (2004). Your health is in your hands:. Fort Worth Business Press17(12), 36.

 

Background Information

Hand washing is the number one way to prevent the spread of infections in hospitals. It has been proven to be more effective than simple alcohol sanitizer base products.  Smith (2009) confirmed that, “It seems that if hand washing with soap, either plain or antimicrobial, is important in containing infections and/or preventing their spread in primary care and community settings, the hand-washing technique may play a crucial role.” Effective hand washing should take at least 20 seconds, or the ever so popular singing of the song “Happy Birthday”.  You need to make sure you wash both front and back of your hands as well as in between your fingers  because this is where most of the germs can attach because of the items we pick up and touch throughout the day. People with long fingernails need to make sure they are getting under their nails  as well as women and men with rings because germs can be attached there too. A part of the hand that needs to be washed that is often overlooked are the wrists, they come in contact with just as much germs and need to be included in the hand washing process. I as a future nurse need to take this into consideration and make sure I’m washing my hands regularly as well as my other coworkers. Everyone else as patients need to speak up if they don’t see their nurse or doctor taking these precautionary measures. Alex-Hart & Opara (2011) stated that, “Hospital acquired infections complicate 7-10% of hospital admissions… these infections result from the transmission of microorganisms from the hands of health workers in health institutions.” This statistic proves that transmission of bacteria can happen anywhere and it is important to wash hands everywhere, not just in hospitals. If more people washed their hands, then less bacteria and infections would be transmitted in and out of the hospital.

 

Citations:

Alex-Hart, B., & Opara, P. (2011). Handwashing Practices amongst Health Workers in a Teaching Hospital. American Journal Of Infectious Diseases7(1), 8-15.

Smith, S. (2009). A review of hand-washing techniques in primary care and community settings. Journal Of Clinical Nursing18(6), 786-790. doi:10.1111/j.1365-2702.2008.02546.x

 

 

 

Introduction:

The topic I have chosen to blog about is near and dear to my heart. I am a senior Nursing major at Longwood. There are so many current issues that nurses, doctors, and patients face every day that it was  hard to choose just one main idea to focus on. The current issue I have chosen to focus on is one of the most important preventive disease measures that everyone can take; hand washing in hospitals. Hand washing is such a simple task and is often far too overlooked. If more nurses, doctors, and patients knew the effect of simple hand washing and how it prevents bacteria from spreading, then more people may be inclined to wash their hands.