Typically, most disease-causing organisms spread through human activities. When a person has contact with an infected surface, they later transfer and introduce germs to other surfaces or areas through physical contact. In this situation, hand hygiene emerges as one of the most critical techniques of reducing the spread of infections. In healthcare settings, hand hygiene is usually emphasized not only for infection control but also to ensure general safety and cleanliness. Regardless of its importance, studies indicate that most healthcare workers rarely practice hand hygiene (Vermeil et al., 2019). According to recent statistics carried out at Healthwealth Medical Center, Hospital Acquired Infections have increased in the last few months. A subsequent investigation into the matter revealed that health workers overlooked hand hygiene practices, with most preferring to wear gloves instead of cleaning their hands with soap and water or using alcohol-based sanitizerss. This paper seeks to create a quality improvement initiative to increase hand hygiene practices among health workers at the Healthwealth healthcare facility.

Projected outcomes

Health workers run the risk of exposure to harmful substances, bacteria, and viruses throughout their practice. As primary caregivers, the interaction between health workers and patients presents an opportunity for infection spread within a healthcare facility. In this context, the current quality improvement initiative seeks to achieve several outcomes. Firstly, it intends to increase hand hygiene among health workers, with each worker expected to practice hand hygiene more than 70 times per shift, or according to the nature of the care given. Additionally, the initiative aims to promote and improve communication and education concerning the suitability of various approaches to ensuring hand hygiene within healthcare settings.  Additionally, the program seeks to involve patients in practicing hand hygiene. Individually and collectively, all the outcomes projected from the quality improvement initiative aim at reducing Hospital Acquired infections and personnel and patient safety within the facility.

Evidence from studies

According to Alefragkis et al. (2019), HCAIs are a principal cause of patient morbidity and mortality within healthcare settings. Although hand hygiene is recognized as the most effective and efficient infection control strategy, a sizeable portion of health workers rarely complies with hand hygiene standards. Typically, infections spread through several sequential steps. Firstly, microbes and pathogens on the skin and the area around the patient come into contact with the healthcare professional’s hands, body, or clothes. Secondly, the pathogens on the healthcare worker spread rapidly due to ineffective cleaning and hand hygiene. Eventually, the health worker transmits infections to other providers and patients who unknowingly spread the infection within and outside the healthcare facility. Although the World Health Organization highly recommends hand hygiene, most healthcare workers cite skin irritation and dryness as the main reason for non-compliance. Additionally, shortage of staff, lack of equipment, and improper communication hinder hand hygiene programs.

As Arbogast et al. (2016) stated, most illnesses stem from hand infections emanating from touching infected surfaces in the workplace. According to recent research, thousands of bacteria thrive in most common places such as the faucet sinks, desks, and doorknobs. Poor hand hygiene causes illnesses, hinders productivity, and results in losses. Annually, the United States loses over $250 billion due to absenteeism resulting from workplace-related infections. Although there are several preventive strategies, infections within workplaces remain high due to the constant physical contact among employees and clients. In these circumstances, hand hygiene remains the most critical approach to combat occupational-related cross infections. According to research conducted within and outside healthcare settings, most employees prefer using alcohol-based sanitizers over handwashing with soap and water. Consequently, hand hygiene programs involving the use of alcohol-based handwash were more successful, with employers witnessing increased hand hygiene and less infection-related absenteeism at the workplace.

Hand hygiene is the most manageable and practical infection control technique. Notwithstanding, most health workers do not adhere to hand hygiene practices (Sands & Aunger, 2020). While research has exhaustively investigated the centrality of hand hygiene in healthcare, there is little research concerning psychological aspects that influence hand hygiene compliance trends among healthcare providers. In light of this gap, formative research is essential in investigating situations that promote and inhibit hand adherence to hand hygiene practices. Nurses’ motivation, roles, norms, attitudes, and institutional factors greatly influence compliance with hand hygiene. In this context, healthcare environments that promote openness, communication, self-responsibility, and increased patient-provider interactions are more likely to uphold hand hygiene.

Implementing the quality improvement initiative

The current state of affairs at the Healthwealth healthcare facility requires a systematic implementation of a quality improvement program to inform and increase hand hygiene. The process will involve rigorous procedures and an implementation team consisting of departmental team leaders. Primarily, the implementation process will be as follows:

• Listing and prioritizing hand hygiene improvement opportunities

As stated, recent research at the facility reveals a significant increment of Hospital Acquired Infections relating to poor hand hygiene practices among health workers and patients. In this context, the implementation team has identified hand hygiene as the top priority. Additionally, the team has established various opportunities for improving hand hygiene practices within the facility.

• Defining the objectives

The overall aim of the hand hygiene initiative is to promote patient safety and enhance patient outcomes. However, there are measurable goals expected to be attained in the course of implementation. Firstly the team expects all health workers to practice hand hygiene at least 100 times per shift according to the intensity of the care given to the patients. Additionally, the initiative intends to increase patient participation in the implementation of the hand hygiene program.

• Collection and organization of data

The quality improvement initiative will employ surveys in collecting information from all healthcare providers within the facility. Individual responses will be more accurate and resourceful regarding the matter at hand.  Besides, the implementation team will create and administer departmental questionnaires to elicit collective responses from various groups working at the center.

• Selecting the root cause of non-compliance to hand hygiene

Hand hygiene is n complex issue in healthcare. A wide range of aspects influence compliance to hand hygiene practices among healthcare workers. The implementation team holds several reasons for the situation. These include skin dryness and irritation caused by repeated hand washing. Regardless, the team believes that more solid underlying issues should be addressed in implementing the initiative.

• Developing possible solutions

The implementation team will explore various ways of increasing hand hygiene within the facility. Some possible solutions include educating and training all healthcare providers on hand hygiene, investing in hand hygiene equipment and resources, increasing staff numbers, and using incentives to increase hand hygiene practices.

• Selecting the best approach/solution

After brainstorming, the implementation panel will select the best possible solutions to increase hand hygiene. Alternatively, the team will choose the best individuals and teams to lead the facility’s implementation process from different departments. Such an approach will ensure that the quality improvement initiative flows seamlessly throughout the organization.

• Implementing the solutions and evaluating the outcomes

As appointed, each departmental/team leader will implement the solutions resolved by the organization’s implementation team. Besides, all team leaders will assess hand hygiene compliance against the guidelines set by the organization’s implementation committee. In evaluating the results, departmental team leaders will employ chart audits to measure hand hygiene compliance among their members. Furthermore, chart audits will be useful in assessing which barriers hinder the implementation of the hand hygiene program.

• Continuous tracking of progress.

Each department will conduct monthly chart audits to track the progress of the hand hygiene initiative. The results will be handed over to the facility’s top management and the implementation team. Depending on the results, the implementation team will develop a plan of action. For instance, if the chart audits display higher trends of non-compliance to hand hygiene, it will create a suitable action plan that might yield more favorable outcomes.

Variables, hypothesis, and statistical measurement

There quality improvement program involves several variables. These include healthcare providers, hand hygiene practices, and the incidences of Hospital Acquired Infections. The chosen variables are increased compliance to hand hygiene and incidences of Hospital Acquired Infections. Respectively, they represent the independent and dependent variables. These variables will be measured according to the information obtained from the chart audits to determine the progress and success of the quality improvement initiative. Additionally, a statistical test will be employed to calculate the accuracy of the hypotheses.

Reference

Alefragkis, Dimitrios & Alikari, Victoria & Kelesi, Martha. (2019). The importance of hand hygiene in health care settings. 102-105.

Arbogast, J. W., Moore-Schiltz, L., Jarvis, W. R., Harpster-Hagen, A., Hughes, J., & Parker, A. (2016). Impact of a comprehensive workplace hand hygiene program on employer health care insurance claims and costs, absenteeism, and employee perceptions and practices. Journal of occupational and environmental medicine, 58(6), e231.

Sands, M., & Aunger, R. (2020). Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study. Plos one, 15(4), e0230573.

Vermeil, T., Peters, A., Kilpatrick, C., Pires, D., Allegranzi, B., & Pittet, D. (2019). Hand hygiene in hospitals: anatomy of a revolution. Journal of Hospital Infection, 101(4), 383-392.