The purpose of this essay is to analyze and contrast various methods of hand washing in the perioperative setting. The essay will also evaluate the impact of hand washing on preventing healthcare acquired infections (HCAIs).
Thoroughly washing hands is crucial for eliminating bacteria and preventing healthcare-associated infections (HCAIs). This article will examine the distinctions between surgical hand wash, social hand wash, and the use of alcohol rubs. According to Pirie (2010), hand hygiene has become increasingly important for healthcare workers in perioperative practice. Furthermore, Muralidhar and Muralidhar (2007) noted that HCAIs present a significant issue for patients and healthcare services as a whole. Moreover, hospitals are encountering challenges in maintaining elevated levels of hygiene to deter the occurrence of HCAIs.
Resources (2008) state that health care workers may carry various pathogens, including bacteria, viruses, and fungi, on their hands. While some of these pathogens are harmless, others pose a serious risk to patients in hospitals. Particularly concerning pathogens mentioned by Resources (2008) include Methicillin Resistant Staphylococcus Aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), Clostridium Difficile, and Influenza Virus.
The Health Protection Agency (2010) also states that Hospital-acquired infections (HCAIs) are most likely transmitted through direct skin-to-skin contact between individuals. For example, if a healthcare worker touches one patient’s hand and then proceeds to touch another patient without washing their hands, the transmission of HCAIs can occur.
According to the Parliamentary Office of Science and Technology (2005:1), approximately 9% of in-patients in the UK have an HCAI at any given time. This translates to a minimum of 300,000 HCAIs per year.
According to Damani (2003), HCAIs in the UK may result in 5,000 deaths and contribute to over 15,000 deaths annually. It is crucial to maintain good hand hygiene as many daily tasks involve using the hands, making them a primary source of HCAIs. Although breaking the infection chain is challenging, hospitals can implement specific measures to minimize the spread of infections (Coyne et al, 2010). These measures include using standard precautions such as wearing appropriate personal protective equipment (PPE), practicing proper hand washing techniques like social or surgical hand wash, and ensuring safe disposal of sharps and waste materials (Coyne et al, 2010).
The Royal College of Nursing (2012) states that healthcare staff will always have bacteria on their hands, but while their own bacteria may not be harmful, they may have picked up other bacteria from their daily tasks. It is not possible to completely sterilize hands, but good hand hygiene can significantly reduce the attached bacteria (The Royal College of Nursing 2012). In Weston’s (2008) study, social hand washing is described as a daily routine that involves using soap and water to remove soil and potential cross contamination. This process is done before and after patient contact, before and after handling patient belongings or food, and for personal hygiene. Social hand washing involves forcefully rubbing both hands together with soap before rinsing under fresh water (Weston, 2008).
Before undertaking a surgical hand wash, it is important that hands are socially clean (Pirie, 2010). Following the hospital’s policy, which should outline the method and agent to be used, is recommended for a surgical hand wash (Goodman & Spry, 2009). As stated by Tanner et al, 2008 (cited in The Association for Perioperative Practice, 2010), the purpose of the surgical scrub is to eliminate or neutralize transient microorganisms and inhibit the growth of resident microorganisms. The surgical hand wash can provide protection against HCAIs in the operating theatre for a limited time (Tanner et al, 2007).
According to Stainton (2009), the surgical hand wash is more rigorous and extensive compared to the social hand wash. Stainton (2009) provided a description of the surgical hand wash technique, which involves washing the hands, nails, and forearms with an antiseptic soap, covering a distance from the fingertips to at least 5cm above the elbow.
There are several distinctions between the social hand wash and the surgical hand wash. The social hand wash is quicker and primarily focuses on cleaning the hands. In contrast, the surgical hand wash takes more time and covers a larger surface area. Additionally, different solutions are used for each type of hand wash. According to Denham (2007) and cited in Ghorbani et al (2011:67), Kampf and Ostermyer (2011) have concluded that alcoholic solutions are more effective than other solutions.
According to Timby (2009), alcohol based rub offers several advantages compared to soap and water. It does not require a fresh supply of water, eliminates the need for sinks, and is easier to perform. Additionally, CCAR (2007) emphasizes that alcohol hand rub saves time and acts faster since it can be used while walking, enabling staff to use their time more efficiently. Furthermore, CCAR (2007:1) provides instructions for using the alcohol rub, including the removal of all jewellery due to its difficulty to clean and lingering bacteria. Visible cleanliness of hands is also important before applying the rub, and if not clean, a social hand wash must be completed. The recommended amount of alcohol rub is ‘1 to 2 pumps’, which should be spread over all surfaces of the hands, ensuring coverage of fingertips, between fingers, back of hands, and base of thumbs as these areas are sometimes missed (CCAR 2007).
This essay has illustrated the significance of hand hygiene in a healthcare setting and the strategies to minimize healthcare-associated infections (HCAIs). I have identified different techniques used in the perioperative setting to reduce bacteria, such as surgical hand wash, social hand wash, and alcohol-based rub. I have explained and compared these methods to highlight their distinctions. The research by Ghorbani et al, 2012 (cited in Wilson, 2012), clearly supports the notion that hand hygiene plays a crucial role in minimizing microbial contamination.
This essay demonstrates the impact of hand hygiene on healthcare-associated infections (HCAIs) and the most effective approach to reduce the risk of patients contracting infections like MRSA. According to Institution for Healthcare (2011), proper hand hygiene can prevent infections in both patients and healthcare workers. Healthcare & Professions Council (2012) emphasizes that all healthcare professionals must take appropriate precautions to safeguard service users and themselves from infections.
(2010) ‘Surgical Hand Antisepsis’ Surgical Hand Antisepsis. (1) pp. 1-2 CCAR: Hand Hygiene for Health Care Settings. (2007) Infection Prevention and Control Best Practices.
http://www.phac-aspc.gc.ca [Accessed 21 May 2013] Coyne, I.
Timmins, F. Neil, F. (2010) Clinical Skills in Children’s Nursing. New York: Oxford University Press Damani, N.
(2003) Manual of Infection Prevention and Control. 3rd ed. New York: Oxford University Press Denham, J. (2001) ‘Surgical Hand Washing/Disinfection’ Journal of Hospital Infection.
pp 21-37 Ghorbani, A. Shahrokhi, A. Soltani, Z. Molapour, A.
Shafikhani, M. (2012) conducted a study comparing the effectiveness of surgical hand washing and alcohol surgical hand rub in reducing hand microbial burden. The findings were published in the Journal of Perioperative Practice, volume 22, issue 2, pages 67-70, authored by Goodman, T & Spry, C.
(2009) Essential of Perioperative Nursing th ed. Burlington: Jones & Bartlett Learning Health Care and Professions Council (2012) Standards of Conduct, Performance and Ethics. You must handle the dangers of infection fairly and safely.
The website http://www. hpc-uk. org/ was accessed on 26 May 2013. The Institution for Healthcare Environment (2011) provides a ‘How-to Guide: Improving Hand Hygiene’ that can be found at http://www. shea-online.
The website “org” was accessed on 26 May 2013. Murakidhar, V & Murakidhar, S. (2007) wrote a book titled “Hospital Acquired Infections” which was published in New Delhi by Anshan National Protection Agency in 2010. Public Health England provides general information on Health Care Associated Infection (HCAI).
hpa.org.uk/ [Accessed 21 May 2013] Parliamentary Office of Science and Technology. (2005) ‘Infection control on Healthcare Setting’ Post Note.
247. pp 1-4 Pirie, S. (2010)’ Hand Washing and Surgical Hand Antisepsis’ Journal of perioperative Care. 20 (5).
pp 169-172 Resources, J. C. (2008) Hand Hygiene. Illinois: Joint Commission on Accreditation of Healthcare Organizations The Royal College of Nursing.
(2012). Wipe it Out: One Chance to Get it Right. Essential Practice for Infection Prevention and Control. http://www.
rcn.org.uk/ [Accessed 21 May 2013] Stainton, K. Hughson, J.
Funnell, R. Koutoukidis, G. Lawrence, K. (2009) Tabbners Nursing Care: Theory and Practice.
Australia: Elsevier. Tanner, J. Blunsden, C. Fakis, A.
‘National Survey of Hand Antisepsis Practices’ is an article published in the Journal of Perioperative Practice, specifically on pages 28-36. It was written by Timby, B. K. as part of the book ‘Fundamental Nursing Skills and Concepts’ in 2009.
9th edition of Infection Prevention and Control by D. Weston (2008) published by Wolters Kluwer Lippincott Williams & Wilkins Malaysia and John Wiley & Sons Ltd West Sussex (Wilson, R).
(2012) ‘Minimising the Spread of Infection in the Operating Department’ Journal of Perioperative Practice. 22 (6). pp 185-188
