Hand Washing In Hospital Setting

Handwashing has traditionally been one of the most efficient methods of illness prevention. This is an easy activity that provides rewards in terms of maintaining our health and safety. Additionally, handwashing is a critical component in COVID-19 prevention. Therefore, more than ever, as we adjust to the new ordinary and survive with COVID-19, washing hands must become an essential part of our daily routines and lifestyles to prevent us from an illness during and after the pandemic.'(Bazaid et al., 2020).

Since COVID-19 expanding mainly through indirect, direct (via contaminating items or objects), or close exposure with affected individuals via the mouth and nasal fluids, handwashing with soap and running water is essential (Bazaid et al., 2020). The use of handwashing in regular periods, after coughing or sneezing, aftercare, using the bathroom, before eating, during food preparations, and after the processing of animals or animal, wastes is a need to halt the spread of COVID-19 together with other COVID suitable behavior. Handwashing after contacting everyday objects such as doorknobs or handles or after returning home from a public location protects us and those around us.

However, nurses are in the vanguard of efforts to contain the rapidly spreading illness. Because hospitals are a hotspot for COVID infections, those responsible for direct patient care are critical in preventing the virus from spreading to uninfected patients inside the hospital (De Angelis et al., 2021). This study was prompted by the greater danger of the virus spreading. Nurses may result in severe consequences to patients and other hospital personnel. In their work with patients suspected of acquiring the virus and those receiving viral screening before admitting, during hospitalization, when a clearing COVID license is required, nurses come into contact with various patients. Researchers must investigate the effectiveness of nurses’ hand hygiene since they can transmit viruses from sick people or surfaces to infectious illnesses in the hospital.

Problem Statement

The aim of this paper is to identify how hand washing, as opposed to not hand washing, reduces infection among nurses providing treatment in hospitals during the COVID pandemic.

Literature Review

On the other hand, nurses are in the vanguard of efforts to contain the rapidly spreading illness. According to Haque (2020), because hospitals are a stronghold for COVID infections, those in charge must be held accountable for direct patient care are critical in preventing the virus from spreading to uninfected patients inside the hospital. This study was prompted by the greater danger of the virus spreading. Nurses may represent a danger to patients and other hospital personnel. Nurses encounter patients suspected of contracting the virus and those undergoing viral testing before admitting, during inpatient, or when a clearing COVID license is needed (Haque, 2020). It is critical to do the study on the efficacy of nurses’ hand hygiene since they may readily spread the virus from infected individuals or surfaces to untreated patients in the hospital.

Washing hands is a critical component of viral prevention and control. Nurses are essential in reducing infection rates in healthcare facilities since they are the primary caretakers and come into touch with patients more often than doctors do. They have a considerable danger of transmitting an infection to a patient when providing treatment. The virus is spread when an infected individual comes into touch with contaminated respiratory droplets or objects exposed to an infectious person. It is transmitted to healthy individuals when they contact infected hands and touch their nose, eyes, or mouth. As a result, the hands are a critical component of microbe transmission (Edmond-wilson et al., 2015), and the culture of handwashing will substantially decrease infection rates inside a facility. As per the Centers for Disease Control and Prevention, hand hygiene remains an activity that needed more attention and improvement (CDCP, 2020). However, the practice acquired increased importance during the COVID epidemic because of its efficacy (Alzyood, 2020). They stress in a statement that when screening for symptoms during admission, practitioners should practice good hand hygiene as a safeguard against hospital-acquired illnesses.

Furthermore, since the pandemic outbreak, hospitals have improved their compliance with hand standards of hygiene. A research study of the effect of COVID on healthcare hand hygiene practices shows a 10% increase in hygiene standards during the pandemic. According to the report, the rise in handwashing habits aided in the virus’s containment. This may be a critical stage in modifying behavioral patterns associated with hand hygiene (Moore et al., 2021). According to the report, the increase in handwashing activities was prompted by the growing significance of virus control (Moore et al., 2021).

Additionally, the infection presented a significant danger to in-house staff members and patients.   Several nurses recognized the technique as feasible and have continued to use it to safeguard themselves, their patients, family members, and the healthcare industry. To protect themselves, they adopt this proof approach to assisting in preventing and controlling disease transmission. According to research from major regulatory organizations like the WHO and academics, hand cleanliness is critical in preventing the information of the virus. Therefore, it is essential for practicing nurses to instill a culture of handwashing in themselves and those around them. Finally, the infection will be confined inside the confines of medical facilities.

A new coronavirus strain was discovered in China, and has spread globally, creating a pandemic (Dwipayanti et al., 2021). The virus strain was named severe respiration syndrome. And it is the causative agent of COVID-19, which has a high contagious rate in humans (Dwipayanti et al., 2021). The infectious nature of the illness, the increasing number of patients, daily fatalities, and an absence of treatments have resulted in an epic healthcare catastrophe. Currently, the pandemic had resulted in over 14 million illnesses and 683000 fatalities globally (Dwipayanti et al., 2021). Till 20th July 2020, Saudi Arabia has reported 253,349 cases with 2523 fatalities (Haque, 2020).

Early investigations indicated that SARS Coronavirus 2 is spread directly via respiratory droplets from sick people or contaminated objects, according to Haque (2020). Notwithstanding, as more information on the virus becomes available, the WHO has expanded the potential modes of transmission to comprise mother-to-child, fomite, droplet, aerosol, fecal-oral, bloodborne, human-human contact, and animal-to-human transmission (Ragusa et al., 2021). This virus seems to have a 14-day gestation period in affected people who exhibit typical symptoms such as cough, fever, and breathlessness or who are asymptomatic (Stangerup et al., 2021). SARS-ability CoV2 potentially causes health problems in a cross-section of contaminated people in a short period, with catastrophic implications for acute and chronic pneumonia. To heart failure, multi-organ dysfunction, cytokine storm, and respiratory distress poses a unique challenge and responsibility to healthcare insurance facilities worldwide (Stangerup et al., 2021). Thus, the spreading of the SARS-CoV2 virus from healthy individuals is a significant preventive issue for controlling this virus (Ragusa et al., 2021).

According to Ragusa et al. (2021), nations across the globe implemented extraordinary preventive measures in reaction to the announcement of a worldwide pandemic on March 11, 2020. The WHO advised the public to only get information on COVID-19 from well-respected sources and to take precautions such as social distance, hand cleanliness, and not touching the nose and mouth with dirty hands (Stangerup et al., 2021). Earlier, it was claimed that increasing public education regarding the necessity of washing hands had resulted in past Covid-19 epidemics in Saudi Arabia being contained (Gasteiger et al., 2020). As a result, the Saudi Ministry of Health established several initiatives to help reduce the new SARS-CoV2 epidemic, based on experience. These sought to raise public awareness and understanding of SARS-CoV2 transmission patterns, COVID-19 infection symptoms, including fever, dry cough, and tiredness, and the preventive actions that go along with them (Gasteiger et al., 2021).

Recent investigations performed in Saudi Arabia revealed a high degree of knowledge among the Saudi public concerning social distancing as a preventative measure to limit the transmission of Covid-19, and observance to this strategy was found to be acceptable in controlling the virus’s spread (Bazaid et al., 2020). Personal data on the Saudi population’s overall education and experience of other safeguards would assist in bridging the gap among perceived notions and practice, allowing decision-maker and community health workers to assess global conversation and ability to adhere to these prevention methods to address any deficiencies through appropriate aimed means and advertisements.

On the other hand, Hand washing is widely regarded as a critical step for avoiding the spread of the Severe Acute Respiratory Syndrome Covid-19 virus, which triggers Coronavirus illness. Hand washing is easy, inexpensive, and among the first lines of defense against the present pandemic’s transmission. It should be done correctly for at least twenty seconds with water and soap (Bazaid et al., 2020). Respiratory infections exacerbated by viruses such as Corona spread when virus-infected mucus or droplets enter the body via the eyes, nose, or throat. This occurs most frequently as a result of encounters with infected hands. The danger of COVID-19 infection is further increased when individuals come into contact with an infected person or when they come into contact with surfaces that have been polluted by an infected person (Stangerup et al., 2021).

Coronaviruses that exist on the hands can be eliminated by regular handwashing with water and soap. If a person’s hands are contaminated, there is a small possibility that they may transmit the virus to other individuals’ eyes, noses, or mouths and whenever they touch their faces (Stangerup et al., 2021). There is now a systematic study examining hand washing and the risk of respiratory infection, and it concluded that hand washing might significantly reduce the risk of infection by 16 percent (Ahmed et al., 2020). It is thus critical to wash hands often and properly to prevent the transmission of COVID-19 (Ahmed et al., 2020). Hand cleaning correctly entails five critical steps.  Compliance with prescribed hand hygiene procedures is critical for preventing the transmission of COVID-19. Regardless, there is abundant evidence that handwashing behaviors continue to be an issue that needs development in many contexts (Ahmed et al., 2020). Pogrebna et al. recently discovered that a nation’s handwashing practice is a very strong determinant of the extent of COVID-19 dissemination (Ahmed et al., 2020).

Theoretical or Conceptual Framework

Handwashing is a simple but very efficient method of preventing infections and illnesses (Ahmed et al., 2020). The Medical Model, the Performance expectancy, and the Theories of Planned Behavior and its expansions serve as the foundation for the majority of handwashing research (Stadler & Tschudin-Sutter, 2020). Among these theories, the Theory of Reasoned Action (TPB) is the most frequently utilized conceptual model (Stadler & Tschudin-Sutter, 2020). According to TPB, the purpose is a major driver of behavior. It is affected by attitudes, subjective standards, and perceived behavioral restrictions. According to this idea, handwashing habits are motivated by the following factors: good or negative assessments, societal pressures, and an individual’s judgment of the degree of ease or difficulty (White et al., 2015).

Numerous handwashing research has followed TPB by concentrating only on behavioral elements of hand hygiene. For example, Gaube et al. (2021) used TPB to develop a program to increase handwashing habits among university students. Their findings indicate that despite students’ attitudes about handwashing did not alter as a result of the ad, more students (12%) did use soap. TPB was also used by Martos-Cabrera et al. (2019) to evaluate handwashing habits amongst public health students. The authors demonstrate that, although public health students’ views toward handwashing are typically favorable, they often violate recommended handwashing procedures.

Ethical Consideration

The Ethics Board at the University of Ha’il approved the research protocol, questionnaire, and permission declaration under the reference number H-2020-80. Individuals interested in participating in this survey were led to the questionnaire after clicking the ‘Continue’ option.

Methods/Sample and Sampling

Study Samples and Design

The results of an epidemiological study conducted between March 25-17th April 2020, using a cross-sectional survey methodology and online self-reported interview questions to evaluate people’s awareness of COVID-19 and the population’s adherence to safety precautions while leaving the house, were published in April 2020. Further questions regarding the usage of masks and gloves, as well as hand washing, were asked of participants who had already been recruited for an assessment of their commitment and knowledge to social distance (home staying) prior to the study. In order to guarantee broad dissemination to the target audience and a varied sample of responders from a variety of sociodemographic backgrounds, the questionnaire was prepared in English and disseminated online via diverse social networking sites. Participants were able to access the questionnaire in a short period of time, and after completing it, their responses were exported as well as examined. The sampling size was estimated utilizing the G-Power program, which is available on the internet on the basis of a multiple regression test with a 5 percent alpha error, 95 percent power, and the capacity to include 32 variables in the model with a 5 percent alpha inaccuracy and 95 percent power.

System for Measuring and Evaluating

The self-reported survey was developed in accordance with the Saudi Ministry of Health and WHO standards to assess the Saudi public’s awareness and responsibility to preventive measures such as hand cleanliness, wearing gloves and masks and eliminating handshaking (CDC, 2020). To assure the survey’s accuracy and relevance to the study’s goals, questions were verified and reviewed by five volunteer interdisciplinary specialists. Additionally, the survey’s wording and clarity were evaluated via a pilot study with 20 members of the general public representing various age genders and groups. The input from both validation groups resulted in the final version of the questionnaire, which includes clear, succinct, and simple questions that meet all of the research’s goals.

The introduction portion of the questionnaire contained information on the purpose, goals of the study, and information on how to get permission to participate in the study to ensure that participants were voluntarily participating in the study. In addition, questions regarding participant anonymity and confidentiality were added to the questionnaire. In general, the questionnaire was divided into three parts. For the first part of the survey, participants were asked about their sociodemographic traits. The second portion of the questionnaire, comprised of yes/no questions, was intended to ascertain individuals’ awareness of the probability of SARS-CoV2 infection. As per Centers for Disease Control and Prevention, transmission occurs when people come into touch with contaminated surfaces and are unfamiliar with appropriate handwashing practice (CDC).

Additionally, interviewees were requested to pick the most preferable way from a list of preventive measures as a means of limiting the Corona spread based on their understanding. The measures included hand washing before contacting the face, using a mouthwash, getting the influenza vaccination, taking vitamins to boost immunity, or avoiding contact with chronic illness patients. The last portion of the survey consisted of six questions designed to assess individuals’ use of protective measures while leaving the house. A gradient scoring system with values ranging from 0 to 2 and 0 to 6 was employed (See figure 1). Each answer provided by respondents in response to survey questions was given a point value; the most acceptable response got one point. The least appropriate response and those showing a lack of practice or incorrect response were awarded a point value of zero. Regarding queries on application frequency, a gradient grading system was employed, with responses including the phrases “always,” “often,” and “sometimes” earning one, half. Six points were the maximum score that a person could get in this research by strictly adhering to protective measures while leaving the house. Participants who scored more than one or greater than three are regarded to have a high level of knowledge or practice, respectively.

The Statistical Program for the Social Sciences 25.0 software package was used to conduct statistical analyses. Appropriate analysis was performed to identify the number of individuals, the participant’s share, the average, the standard deviation, and the median concerning factors that indicate knowledge and practice. Using the Chi-square test or Fisher’s exact test for discussion questions, it was determined whether or not there were any statistically significant variations in responses regarding demographic factors (Karim et al., 2020). The responses to the two statements were merged and treated as ordinal data on a scale of 0–2 on a scale of 1–3 on a scale of 1–3. A quantitatively substantial difference in total education level between groups was determined using either the Kruskal-Wallis H test (more than two groups) or the Mann-Whitney U test (2 groups). To determine which demographic factors are associated with overall practice scores, the Stepwise method of multiple linear regression was used. Calculating odds ratios, unstandardized regression coefficients, and 95 percent confidence intervals allowed us to determine whether there were any statistically significant relationships between variables.

Summary

COVID19 is now spreading across the globe, with practically no area remaining unaffected. Because of the rapidity with which COVID19 has spread and the frightening mortality rates, several nations and jurisdictions have implemented steps to limit the transmission of the virus. Handwashing is a key component of all of these efforts. Handwashing has received a lot of attention during the COVID19 outbreak. It is a simple, fundamental preventive measure that the majority of people can do on their own. To begin, handwashing for at least 20 seconds with soap and water or using a liquid hand sanitizer in the absence of soap and water is the most effective way of avoiding disease transmission (CDCP 2019). There is, however, sufficient evidence that handwashing among health workers (HCW) remained a problem in need of improvement for many years before the epidemic (CDCP 2020).

Our hands have an important role in transmitting germs (Dwipayanti et al., 2021). These organisms can spread to others if we do not thoroughly wash our hands after handling them. Handwashing programs have been running nearly continuously across healthcare systems and services to urge health-care workers, patients, and visitors to practice good hand hygiene. For example, the worldwide campaign “My five moments for hand hygiene” identifies the critical times during which health-care workers must adhere to hand hygiene regulations when in touch with patients or their surroundings (Dwipayanti et al., 2021). The “Cleanyourhands campaign” was a nationwide program initiated in the United Kingdom to increase medication adherence among healthcare workers to decrease the risk of hospital-acquired illnesses (Ragusa et al., 2021). Among the messages included in the campaign was “It’s OK to ask,” which encourages healthcare professionals to ask to rinse their hands (Ragusa et al., 2021). The campaign also encourages patient involvement in handwashing and collaborative efforts with nursing assistants and other to reduce the spread of pathogens (Martos-Cabrera et al. (2019).

During the current COVID-19 epidemic, there has been an increased emphasis on hand hygiene knowledge and training directed at working in the healthcare industry and the general public. Future public health messages have been disseminated via a variety of channels, stressing the necessity of handwashing and the proper handwashing methods. Handwashing is critical to preventing the spread of COVID19. Hashtags and short videos are being used to reach Individuals are being urged to wash their hands properly using their handheld gadgets and via social networking sites and conventional media outlets such as television, radio, print ads, and billboards.

Handwashing is increasingly regularly mentioned in daily news broadcasts, in addition to having a larger digital media presence and other advertising outlets, as service users, legislators, public personalities, and others participate in handwashing efforts. Greater and more widespread attempts to promote handwashing knowledge, as well as a noticeable rise in individuals expressing out and discussing the significance of handwashing, are laudable.

In our professional experience as Nurses know that hand cleanliness is not consistently regarded as essential, with medical compliance far from ideal throughout time—conformance and adherence (Martos-Cabrera et al., 2019). Washing Compliance with hand hygiene is just 40%. in several studies from various nations (Stadler & Tschudin-Sutter, 2020), with the rate of compliance in intensive care units being just 46.25 percent (Stadler & Tschudin-Sutter, 2020).Even though this is a straightforward and potentially life-saving procedure, it is not always carried out (Stadler & Tschudin-Sutter, 2020). Handwashing has been the center of attention as a result of the current epidemic. We must now make certain that this concentration is maintained.

Even when the epidemic is gone, Nurses must keep promoting handwashing, not just in the medical field but also throughout communities and people in general, with the same enthusiasm and commitment. The substantial increase in interest in encouraging handwashing behaviors that have occurred since the beginning of the COVID19 pandemic should be capitalized on and maintained even after the epidemic has been controlled. This is one-way nurses may contribute to the security protecting their communities against this and the plethora of other infectious organisms that pose a threat.