Transcript of Group Members Santana Suckra Sashonie Taylor Natasha-Lee Roache Tressan Ritchie Tameka Stewart...
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- Group Members Santana Suckra Sashonie Taylor Natasha-Lee Roache
Tressan Ritchie Tameka Stewart Althea Walker
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- Clinical question: Is antiseptic hand washing as effective as
alcohol sanitizer in reducing the rates of hospital acquired
infections?
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- Patient: Hospitalized patients Intervention: Hand washing
Comparison: Alcohol sanitizer Outcome: Reducing the rates of
hospital acquired infections.
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- Introduction In a health-care setting certain procedures and
guidelines are essential and the implementation of hand hygiene is
one such requirement. Hand hygiene involves general hand washing
with the use of soap and water and the use of antiseptic agents
such as antiseptic hand rubs or antiseptic hand wash (Rosenthal,
Guzman & Safdar, 2005).
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- Introduction Contd According to the World Health Organization
(WHO) a hospital acquired infection is An infection acquired in
hospital by a patient who was admitted for a reason other than that
infection. or An infection occurring in a patient in a hospital or
other health care facility in whom the infection was not present or
incubating at the time of admission. This includes infections
acquired in the hospital but appearing after discharge, and also
occupational infections among staff of the facility.
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- It has been noted by that both antiseptic hand washing and
alcohol sanitizers contribute to a reduction of nosocomial
infections during hospitalization. However, some studies concluded
that alcohol hand rubs are more effective in reducing bacterial
contamination during patient care routine compared to antiseptic
hand washing (Girou et al., 2003). Antiseptic hand washing versus
the alcohol hand sanitizer/rubs
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- Another study suggest that antiseptic hand washing is more
effective at removing the Clostridium Difficile bacteria that
result is a nosocomial infection (Jabbar et al., 2010). There are
also studies saying that there is no difference between the
effectiveness of the antiseptic hand washing versus the alcohol
hand rubs (Larson et al., 2005).
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- Study 1: In a randomized qualitative study conducted by Girou
et al. in 2003, twenty-three (23) patients, permanent and temporary
nurses and nursing assistants volunteered to participate. Twelve
(12) health care workers were allocated to hand rubbing with a
waterless alcohol based solution and eleven (11) were allocated to
hand washing with antiseptic soap. Patient care activities were
monitored during daily sessions of 23 hours until a predetermined
number of eligible activities had been performed. The conclusion
was that hand rubbing with an alcohol based solution reduced
bacterial contamination of healthcare workers hands more than hand
washing with antiseptic soap during routine patient care
activities.
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- Study 2: Larson et al. (2005) conducted study using a crossover
design in two (2) neonatal intensive care units inclusive 2932
neonatal hospital admissions and 119 nurse participants. Larson et
al. compared the effects of two (2) hand hygiene regimens in
infection rates between the traditional antiseptic hand wash and an
alcohol hand sanitizer. Each product was used for 11 consecutive
months in each neonatal intensive care unit in random order. The
study concluded that there was no difference seen on the nurses
hands during the hand washing and alcohol phase. However,
assessment of infection rates in a single intervention was limited
because of multiple contributory factors such as patient risk, unit
design, and staff behavior. Other practices such as frequency and
quality of hand hygiene are likely to be as important as product in
reducing risk of cross-transmission.
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- Study 3: This study was a comparison of alcohol based hand rubs
(ABHRs) as an effective means of decreasing the transmission of
bacterial pathogens. Even though alcohol is not effective against
the bacteria known as Clostridium Difficile (C. Difficile) spores.
The study was conducted by Jabbar et al. in 2010 with ten (10)
persons volunteering for C. Difficile to be spread on their bare
palms. The use of three (3) ABRRs and hand washing with
chlorhexidine (antiseptic) soap were compared with plain water
rubbing alone for removal of C. Difficile. The result of the study
stated that there were no statistically significant differences in
the reductions achieved by the ABHRs. Therefore it was concluded
that hand washing with soap and water is significantly more
effective at removing C. Difficile spores than ABHRs and after the
use of ABHRs with a single handshake the residual spores are
readily transferred.
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- Appraisal
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- STUDY 1 This study was conducted with 23 participants in three
intensive care units in a University Hospital in France. 12
participants were assigned to use a hand rubbing agent with a
waterless alcohol based solution and 11 were assigned to hand
washing with antiseptic soap. The participants had already been
instructed on the use of alcohol based solution as there was a
policy that had been implemented 1 year previously in the hospital.
Each ICU had copies of the policies.
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- The study zeroed in on the effectiveness of antiseptic hand
washing over hand rubbing with a sanitizer. This article was
helpful in formulating a generalized conclusion. The results of the
study were formulated by testing the participants hand after hand
hygiene with any products was done. Researchers did this by taking
an imprint of the fingertips and palm of participants dominant hand
1 minute before and after the procedure, to count the amount of
bacteria present.
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- Limitations Some participants were reported to have washed
hands under the recommended 30 second time limit, which would have
been inadequate time for decontamination to be at an optimal level.
Also, there was no suggestion in the article how they
differentiated normal flora from infection-causing bacteria.
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- STUDY 2 This study was centred in two (2) Neonatal Intensive
care units in Manhattan New York which included 119 nurse
participants. The participants were oriented to the study products
and procedures. Also a comparison was done on two hand hygiene
products; they were antiseptic hand wash and an alcohol hand
sanitizer. Both agents were used for 11 consecutive months, where
both were alternated following random order.
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- A six-point scale was used to examine the hand at magnification
x 3. A special technique known as the glove-juice technique used
for sampling was done to differentiate between normal flora and
microbes. The outcome variable in the model was the presence or
absence of any infection in each neonate. The sample size was
adequate for the type of research being conducted as there is a
greater sample size fit for comparison.
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- Limitations In the study, there was no indication that hand
washing procedures were performed within the 30 second time
interval. Infections that were not yet diagnosed (i.e. infections
arising after study was conducted) may have gone undetected.
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- MEDIA
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- References Girou ???. (2003). Efficacy of handrubbing with
alcohol based solution versus standard handwashing with antiseptic
soap: randomised clinical trial. ??? Retrieved from:
http://ebn.bmj.com/content/6/2/54.full.html Jabbar, U., Leischner,
J., Kasper, D., Gerber, R., Sambol, S. P., Parada, J. P.,... &
Gerding, D. N. (2010). Effectiveness of Alcohol Based Hand Rubs for
Removal of Clostridium difficile Spores from Hands. infection
control and hospital epidemiology, 31(6), 565-570. Retrieved from:
http://www.jstor.org/stable/10.1086/652772 Larson, E. L., Cimiotti,
J., Haas, J., Parides, M., Nesin, M., Della-Latta, P., &
Saiman, L. (2005). Effect of antiseptic handwashing vs alcohol
sanitizer on health care- associated infections in neonatal
intensive care units. Archives of pediatrics & adolescent
medicine, 159(4), 377. Retrieved from:
http://archpedi.jamanetwork.com/article.aspx?articleid=485991
Moralejo, D., & Jull, A. (2003). Handrubbing with an alcohol
based solution reduced healthcare workers hand contamination more
than handwashing with antiseptic soap. Evidence Based Nursing,
6(2), 54-54. Retrieved from:
http://ebn.bmj.com/content/6/2/54.short
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- References Contd Rocha, L. A., Nunes, M. J., & Gontijo
Filho, P. P. (2012). Low Compliance to Handwashing Program and High
Nosocomial Infection in a Brazilian Hospital.Interdisciplinary
Perspectives on Infectious Diseases, 2012. Retrieved from:
http://www.hindawi.com/journals/ipid/2012/579681/abs/ Rosenthal, V.
D., Guzman, S., & Safdar, N. (2005). Reduction in nosocomial
infection with improved hand hygiene in intensive care units of a
tertiary care hospital in Argentina. American journal of infection
control, 33(7), 392-397. Retrieved from:
http://www.nursingconsult.com/nursing/journals/0196-6553/full-
text/PDF/s019665530500430x.pdf?issn=0196-
6553&full_text=pdf&pdfName=s019665530500430x.pdf&spid=15731325&article
_id=492627 World Health Organization. (2002). Prevention of
hospital-acquired infections: A Practical Guide 2nd edition.
Retrieved from: http://www.who.int/emc