Research Design Discussion Paper

Research Design Discussion Paper

Noncompliance with hand hygiene practices as a problem in the nursing practice

Poor compliance with effective hand cleanliness practices is a major problem in nursing practice.  The practice of hand hygiene is among the most efficacious strategy for the aversion of healthcare-associated infections (HAIs), but the compliance of healthcare workers is poor. According to Musu et al (2017), all HAIs are not preventable. However, research has demonstrated that most of the infections are preventable via interventions that are based on the effectiveness of evidence. Research Design Discussion Paper

The determinants of HAIs in which there is the possibility of intervening and improving quality of care include practices that fail to meet gold standards in the reduction of the risk of infection poor partaking in interventions reducing or preventing the risk of infection and lack of knowledge for healthcare workers about systems for infection control. Promoting an appropriate adherence to hand hygiene along can be a cost-effective, efficacious and simple strategy. Despite documented evidence that conformity with hand hygiene can lessen the rates of HAIs, noncompliance remains a major problem in nursing care (Musu et al, 2017).

How the problem impacts nursing care and patient outcomes

Noncompliance with hand hygiene affects nursing practice as well as patient outcomes. HCAIs are an important cause of mortality and morbidity.  Poor quality practices of hand cleanliness augment the risk of HCAIs, resulting in a prolonged stay in hospitals and increase health care costs. Even though several factors account for HCAIs, contact transmission is a major pathway.  The current health care environment is complex, with healthcare workers constantly on the move and responding to time-sensitive and stressful work demands. Numbers forms of microbes, including streptococcus pyogenes and staphylococcus aureus, can be transmitted on the healthcare workers’ hands as a result of lapses in hand hygiene (Neo et al, 2016). Research Design Discussion Paper


Numerous studies have revealed that contaminated hands increase the transmission of microbes and HAIs, which are a risk to patients as well as nurses. Hand hygiene by nurses prevents them from contracting infections, but it also minimizes the risk of spreading infections to others. Failure to appropriately wash or disinfect their hands prior to coming into contact with other people can make nurse infect patients and their family members (Milliarou, 2017).  Millions of hospitalized patients are contract numerous types of HAIs globally.  The outcomes of HAIs include severe illness,  lengthy hospital stay, increase hospital costs as well as long disabilities which in turn lead to a financial burden to patients and their families as well as the healthcare system.

Potential solutions to the problem

Nonconformity to hand hygiene can be solved by eliminating factors that prevent healthcare works from observing hand hygiene practices. Researched has demonstrated that the perceived obstacles to hand hygiene include inconveniently located or inaccessible dispensers and sinks, heavy workload, forgetfulness,  lack of scientific knowledge and ignorance of hand hygiene guidelines. Putting dispensers and disinfectants next to patient beds is a remedy to the noncompliance with hand cleanliness. (Milliarou, 2017). Both the Center for Disease Control and Prevention and World Health Organization guidelines recommends healthcare workers clean their hands with water and soap when evidently dirty. On the contrary, alcohol-based hand cleaning is recommended for every other opportunity.  The most significant scheme of preventing and controlling the spread of HAIs is complying with recommendations on hand sanitation (Karaaslan et al., 2014).

Another possible solution to lack of compliance with hand hygiene is increasing awareness among healthcare workers.  Research has demonstrated that increasing healthcare workers’ understanding of hand hygiene leads to improved conformity with hand hygiene.   According to Quilab et al (2019), research has demonstrated that implementation of education strategy increases hand hygiene knowledge among nurses along with a considerable improvement in the rates of compliance following an educational intervention. A visual aid, for instance, posters is another scheme of enlightening healthcare workers about hand hygiene in order to increase compliance rates. Research Design Discussion Paper


Karaaslan, A., Kadayifci, E., & Altici, S et al. (2014). Compliance of Healthcare Workers with Hand Hygiene Practices in Neonatal and Pediatric Intensive Care Units: Overt Observation.  Interdisciplinary Perspectives on Infectious Diseases, 2014: 306478.

Malliarou, M. (2017). Hand Hygiene of Nurses and Patient Safety.  International Journal of Nursing & Clinical Practices, 4:217.  doi:

Musu, A., Lai, A., & Mereu, N et al (2017). Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units. Journal of Preventive Medicine and Hygiene, 58:E231-E237.

Neo, J., Franlklin, E., & Zadeh, R. (2016). An integrated review of evidence-based practices to increase hand hygiene compliance in healthcare facilities. American Journal of Infection Control, 44(6), 691-704. doi: 10.1016/j.ajic.2015.11.034.

Quilab, M., Johnson, S., Schadt, C., & Mitchell, A. (2019). The effect of education on improving hand hygiene compliance among healthcare workers.  Hospice & Palliative Medicine International Journal, 3(2), 66-71. doi: 10.15406/hpmij.2019.03.00153  Research Design Discussion Paper