Abstract
Background: during the hospital admission, nurses play a fundamental role in the adherence to hand hygiene (HH) measures by patients and their families, enhancing the quality and safety of care. Objective: synthesize the latest scientific evidence regarding nurse-led interventions focused on hospitalized patients’ adherence to HH and its impact on preventing Healthcare-Associated Infections (HAIs). Methodology: following the PICOD mnemonic, a narrative review was conducted in MEDLINE (via PubMed), CINAHL (via EBSCO), and Cochrane Library. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. Results: seven studies were included for review, published between 2016 and 2018. Three central themes emerged: i) nurse-led interventions that promote patients’ adherence to HH; ii) patients’ HH adherence and HAIs prevention; iii) the importance of person-centered nursing care in this scope. Conclusion: isolated interventions do not lead to adequate behavioural changes. Although educational interventions are the most common actions used by nurses, visual cues, distribution of informational material, provision of HH material, and creation of specific moments for HH are complementary strategies that enhance the efficiency and quality of the intervention.
References
Graveto, J., Rebola, R. I. F., Fernandes, E. A., & Costa, P. J. D. S. (2018). Hand hygiene: Nurses’ adherence after training. Revista Brasileira De Enfermagem, 71(3), 1189–1193. https://doi.org/10.1590/0034-7167-2017-0239
Graveto, J., Santos, C., Costa, P. S., Fernandes, E., Alarico, S., Osório, N., Albano, H., & Oliveira, V. (2018). Hand hygiene management among nurses: Collective health challenges. Revista Brasileira De Enfermagem, 71(suppl 1), 562–567. https://doi.org/10.1590/0034-7167-2017-0538
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ Hand Washing and Reducing Hospital-Acquired Infection. Critical Care Nurse, 37(3), e1–e8. https://doi.org/10.4037/ccn2017694
Istenes, N., Bingham, J., Hazelett, S., Fleming, E., & Kirk, J. (2013). Patients’ potential role in the transmission of health care-associated infections: Prevalence of contamination with bacterial pathogens and patient attitudes toward hand hygiene. American Journal of Infection Control, 41(9), 793–798. https://doi.org/10.1016/j.ajic.2012.11.012
Joint Commission (Ed.). (2009). Patients as partners in the infection prevention and control process. Joint Commission Resources.
Kickbusch, I., Pelikan, J. M., Apfel, F., Tsouros, A. D., & World Health Organization (Eds.). (2013). Health literacy: The solid facts. World Health Organization Regional Office for Europe. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/128703/e96854.pdf
Knighton, S. C., Dolansky, M., Donskey, C., Warner, C., Rai, H., & Higgins, P. A. (2018). Use of a verbal electronic audio reminder with a patient hand hygiene bundle to increase independent patient hand hygiene practices of older adults in an acute care setting. American Journal of Infection Control, 46(6), 610–616. https://doi.org/10.1016/j.ajic.2018.01.005
Landers, T., Abusalem, S., Coty, M.-B., & Bingham, J. (2012). Patient-centered hand hygiene: The next step in infection prevention. American Journal of Infection Control, 40(4 Suppl 1), S11-17. https://doi.org/10.1016/j.ajic.2012.02.006
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
Okada, J., Yamamizu, Y., & Fukai, K. (2016). Effectiveness of hand hygiene depends on the patient’s health condition and care environment. Japan Journal of Nursing Science: JJNS, 13(4), 413–423. https://doi.org/10.1111/jjns.12122
Ong, A. Y. J., Tan, J., Yeo, H. L., & Goh, M. L. (2017). Patient-centred hand hygiene information in orthopaedics units: An evidence-based implementation project. International Journal of Evidence-Based Healthcare, 15(1), 22–29. https://doi.org/10.1097/XEB.0000000000000094
Park, J., & Seale, H. (2017). Examining the online approaches used by hospitals in Sydney, Australia to inform patients about healthcare associated infections and infection prevention strategies. BMC Infectious Diseases, 17(1), 788. https://doi.org/10.1186/s12879-017-2899-2
Pokrywka, M., Buraczewski, M., Frank, D., Dixon, H., Ferrelli, J., Shutt, K., & Yassin, M. (2017). Can improving patient hand hygiene impact Clostridium difficile infection events at an academic medical center? American Journal of Infection Control, 45(9), 959–963. https://doi.org/10.1016/j.ajic.2017.06.019
Rai, H., Knighton, S., Zabarsky, T. F., & Donskey, C. J. (2017a). A randomized trial to determine the impact of a 5 moments for patient hand hygiene educational intervention on patient hand hygiene. American Journal of Infection Control, 45(5), 551–553. https://doi.org/10.1016/j.ajic.2016.12.022
Rai, H., Knighton, S., Zabarsky, T. F., & Donskey, C. J. (2017b). Comparison of ethanol hand sanitizer versus moist towelette packets for mealtime patient hand hygiene. American Journal of Infection Control, 45(9), 1033–1034. https://doi.org/10.1016/j.ajic.2017.03.018
Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2016). Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infections: The attitudes of hospital health care workers. American Journal of Infection Control, 44(3), 263–268. https://doi.org/10.1016/j.ajic.2015.10.003
Srigley, J. A., Furness, C. D., & Gardam, M. (2016). Interventions to improve patient hand hygiene: A systematic review. The Journal of Hospital Infection, 94(1), 23–29. https://doi.org/10.1016/j.jhin.2016.04.018
Sunkesula, V. C. K., Knighton, S., Zabarsky, T. F., Kundrapu, S., Higgins, P. A., & Donskey, C. J. (2015). Four Moments for Patient Hand Hygiene: A Patient-Centered, Provider-Facilitated Model to Improve Patient Hand Hygiene. Infection Control and Hospital Epidemiology, 36(8), 986–989. https://doi.org/10.1017/ice.2015.78
World Health Organization (Ed.). (2009). WHO guidelines on hand hygiene in health care: First global patient safety challenge: clean care is safer care. World Health Organization, Patient Safety. Retrived from https://apps.who.int/iris/rest/bitstreams/52455/retrieve
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Ana Nunes, Joana Carrasquinho, Paulo Santos-Costa, Luciene M. Braga, Beatriz Serambeque, Pedro Parreira, Anabela Salgueiro-Oliveira