Minimizing the Nosocomial Infections through the Alcohol-Based Hand Gels


Minimizing the Nosocomial Infections through the Alcohol-Based HandGels


Extensive research has revealed that the unhygienic conditions in thehospital often lead to the spread of the nosocomial infections. Mosthospitals have adopted the use of the water and soap at specificpoints of care to help the nurses in reducing the germs in theirhands. However, the approach has been ineffective and led to theintroduction of the alcohol-based hand rubs that are more successfulin making the oncology unit much safer. Hence, the implementation ofthe project will initiate total change in the oncology unit and makesure that everyone is on board. The support of every stakeholder willlead to the participants supporting the idea and ensuring that theycomply with the guidelines and ensure that the hospitals are safe foreveryone.

Keywords: alcohol-based hand rubs, nosocomial infections, oncologyunit, hand hygiene, unhygienic conditions.

Minimizing the Nosocomial Infections through the Alcohol-Based HandGels

  1. Problem Description

The spread of the nosocomial infections in the oncology unit has beenmore rampant and resulted in more deaths as well. On the other hand,a hospital is supposed to prioritize the safety of the patients andensure that the environment is safe and free from infections.However, the unhygienic conditions in a nursing setting provide aplace where the pathogens will thrive and spread the infections. Theimplementation of the soap and water to wash the hands of the nurseswas one of the ways that the hospital made (Chen et al., 2011). Inthis case, the soap and water were placed at various points withinthe hospital to make sure that they wash their hands frequently. Thewater and soap techniques were initiated as a way to reduce the handtransmission since the nurses often touch various things within theoncology unit that might be contaminated with the nosocomialinfections. More importantly, the nurses were able to wash theirhands frequently and antiseptic soaps that helped in removing thepathogens that they had handled along the way (Chen et al., 2011).However, the change was not effective since it did not minimize howthe nosocomialinfections were spreading. Often, the nurses did notfollow the right guidelines specified that would have helped inreducing the rate of the morbidity. The failure to reduce theinfections showed that the hospital needed to initiate anotherapproach that will help to reduce the problems that the hospital wasfacing at that time.

  1. Solution Description

The increased rate of the nosocomial infections in the hospitalshowed the need for the immediate solution since the patients in theoncology unit were suffering. In fact, the high morbidity and themortality rate were undermining the image of the hospital, and theprompt solution was the only way of ending the problem. Most of thecancer patients in the oncology unit were undergoing the chemotherapytreatment that often weakens their immunity (Koff et al., 2011). Thescenario meant that the patients were more likely to contract thenosocomial infections since their immunity was more vulnerable.Hence, the introduction of the alcohol-based hand gel is the mostcritical substance that will be used in reducing the rate of thenosocomial infections in the oncology unit. More specifically, eventhe WHO guidelines insist on using the same hand sanitizers sincethey contain the alcohol that is more likely to destroy the pathogensthat the nurses might have on their hands (Mathur, 2011). The handgels will be an important part of reducing the rate of infectionssince they placed at most of the points of care where the nurses willbe expected to use them before they initiate any treatment approach.More importantly, the entire approach will help in promoting thehygienic conditions in the hospital and making sure that thepathogens do not have anywhere that they can survive. The fact thateach nurse will embrace the idea and comply with the strictguidelines specified will be a bold step towards the eradication ofthe infections in the oncology unit.

  1. Implementation Plan

The implementation process will be an instrumental phase of theproject since it will create the step-by-step plan to be followed inthe entire scenario. In this case, the project will begin with theapproval of the Institution Review Board (IRB) that assess if itmeets all the required demands. More importantly, the InstitutionReview Board (IRB) is focused on analyzing if a project associatedwith human beings prioritizes safety and the other elements specifiedin the “Code of Federation Regulations, 45 CFR 46.102d” section(Bolon, 2011). In particular, the implementation process will havesix phases that will specify how the project will be enacted. First,the project will undergo the approval phase where the report willprove its credibility before the board and the other stakeholders.Besides that, the second phase will look at the planning and thedesigning while finding some sustainable ways in which the businesscan find enough funds to finance the project. The third phase willforecast the future of the project while evaluating any loopholesthat might undermine its efficiency. After that, the fourth phasewill insist on the way to educate the stakeholders and answering anyqueries that they might have (Boyce, 2011). The last phase will focuson the official launch, and it will take place in a period of tenmonths after the approval. More specifically, the education of theparticipants will be quite critical since it will ensure that eachone of them has the knowledge on the way that the project works. Forinstance, the pamphlets, handouts, and the PowerPoint presentationswill be helpful as well.

  1. Evaluation Plan

The evaluation plan will assess the entire project and identify thefeedback of the participants. The response will be quite effective indetermining any loopholes in the project and the need to make somecorrective measures if the need arises. The evaluation will look atthe attitude of the nurses towards the alcohol-based hand sanitizersthat the project will introduce (Appendix 1). Apart from that, itwill also look at the current reports to determine the number ofcancer patients in the oncology unit that have contracted thenosocomial infections. Assessing the two variables will help indetermining if the project is in the right direction or not. Moreimportantly, the project will also initiate the education of theparticipants to ensure that they get the information that will guidethem through the entire process (Benning et al., 2011). The use ofthe pamphlets and the handouts will help in reminding them how tohandle the project and make sure that they have control over theinfections. The assessment instruments to be used in identifying thefeedback of the participants will be crucial in analyzing the waythat they have embraced the project fully (Fisher et al., 2012). Inparticular, the evaluation will rely on the questionnaires and thesurveys that will record the feedback from the participants to decidethe way that the project has taken (Appendix 2). From the response,the coordinators will categorize the results and identify theloopholes and correct them to make sure that it functions efficientlylater.

  1. Dissemination Plan

Disseminating the evidence-based practice to the audience will bequite critical since it will create room for understanding theproject and correcting any mistakes it might have. In this case, theuse of a workshop will be more instrumental in coordinating how theparticipants will assist in reaching the goals expected. Moreimportantly, it will have enough space where the participants willobserve the posters that will remind them of the procedure (Colemanet al., 2013). In fact, it will provide a session where they willunderstand what they will do and the specific things that they haveto implement. They will even get a chance to discuss how the issueswill be implemented and they will later air opinions on what is rightand wrong. The discussion will provide room for clarification,disagreement and reaching a common ground (Harris, 2012). Besidesthat, the process will make sure that the participants get a wholepicture and understand the problem they are facing. Besides that,after they have seen the role that they will play in the entireprocess, it is more likely that they will readily support every movethat will make sure that the project is on the right course.

  1. Review of Literature

Alangaden (2011) addresses the unhygienic conditions and proves thatthe nosocomial infections will result in higher mortality rates ifthe hospital does not control the factors. In this case, the centralvenous catheters and the surgery room are some of the factors knownto spread the infections. It shows that the proposed solution will becritical in solving the nosocomial infections. On the other hand,Boyce (2011) looks at the way technology minimizes the likelihood ofthe infections increasing the rate of morbidity and mortality. Inparticular, the research looks at the Electronic hand hygienemonitoring systems that make it easier to comply with the handhygiene requirements. Chen et al. (2011) talk about a hospital thatfocused on strengthening the rate of conformity and ended upacquiring positive results. In this case, the nosocomial infectionseven reduced by 8.9% a progress that proved the proper compliance ishelpful.

Barrera et al., (2011) focuses on the alcohol-based hand rub thathelps in reducing the hospital-acquired infections. In fact, itreveals that the strict compliance with the specified guidelinesdictates the success of the project in eradicating the problemcompletely. Besides that, Bolon (2011) supports the guidelines by theWHO that insists every nurse is supposed to use the sanitized handrubs. More importantly, the paper also reveals how the weakenedimmunity of the cancer patients often leads to the quick spread ofthe nosocomial infections.Huskins et al. (2011) evaluates thebenefits of hand hygiene and analyzes the use of hand rubs, gloves,and gowns in making sure that the patients are free from theinfections. Their results justify the goals of the project and revealthat they will reduce the severity of the problem.

Marwati et al. (2016) how the high costs that the hospital managementhas to incur because of the frequent treatment of the infections area huge burden. Besides that, it reveals that the Surgical SiteInfection (SSI) have turned out to be more common and shows the needfor the prompt solutions as well. Furthermore, Koff et al. (2011)focus on the spread of the hospital-acquired infections and thefactors that encourage the circumstances. In particular, the researchreveals how the unhygienic conditions are the main reason andcontrolling them is the main solution. In the same case, Lake et al.(2016) discuss how the ICU is prone to the infections because thetreatment tends to weaken the immunity of the patients and makes themvulnerable. In fact, it insists that the effort should be placed inthe units to ensure that the patients no longer have to suffer fromthe increased infections. Even Mathur (2011) highlights theinitiatives introduced by various organizations such as WHO that arefocused on reducing the nosocomial infections in the society. Moreimportantly, it shows that the pathogens grow where there is theunhygienic condition.

Salama et al. (2013) analyze the impact of the proper hygieneconditions in a hospital setting and how it helped in minimizing therate of the bloodstream infections. In particular, it is clear thatthe unhygienic condition is the major problem that should becontrolled and ensure that the oncology unit is free from suchinfections. Pincock et al. (2012) evaluate the way that the cancerpatients are at risk of contracting the infections because of thetreatment that they undergo. In particular, it undermines theirimmunity and leaves them vulnerable to any hospital acquiredinfections. It suggests prompt solutions to curb the spread of theinfections as well. Apart from that, Rocha et al. (2012) focus on thesetting of a hospital while suggesting some appropriate ways one canuse in reducing the rate of the infections. The paper highlights thevisual posters and washing the hands use the soap and water however,it does not give the report on whether the approach was successful ornot. Rosenthal et al. (2012) look at the problem by discussing thedevices that are known to spread the diseases in the hospitalsetting. For instance, the ventilator-associated pneumonia is some ofthe common ones that affect the patient. Lastly, Yeung et al. (2011)discuss how to use the alcohol-based hand gels while insisting on theway they reduce the pneumonia infections. More importantly, theresearch shows that the proper compliance and the effective use ofthe hand rubs will control the spread of the infections in the end.


Alangaden, G. J. (2011). Nosocomial fungal infections: epidemiology,infection control, and prevention. Infectious disease clinics ofNorth America, 25(1), 201-225.

Barrera, L., Zingg, W., Mendez, F., &amp Pittet, D. (2011).Effectiveness of a hand hygiene promotion strategy usingalcohol-based handrub in 6 intensive care units in Colombia. Americanjournal of infection control, 39(8), 633-639.

Benning, A., Ghaleb, M., Suokas, A., Dixon-Woods, M., Dawson, J.,Barber, N., … &amp Rudge, G. (2011). Large scale organisationalintervention to improve patient safety in four UK hospitals: mixedmethod evaluation. Bmj, 342, d195.

Bolon, M. (2011). Hand hygiene. Infectious disease clinics ofNorth America, 25(1), 21-43.

Boyce, J. M. (2011). Measuring healthcare worker hand hygieneactivity: current practices and emerging technologies. InfectionControl &amp Hospital Epidemiology, 32(10), 1016-1028.

Chen, Y. C., Sheng, W. H., Wang, J. T., Chang, S. C., Lin, H. C.,Tien, K. L., … &amp Tsai, K. S. (2011). Effectiveness andlimitations of hand hygiene promotion on decreasinghealthcare–associated infections. PLoS One, 6(11),e27163.

Coleman, E. A., Rosenbek, S. A., &amp Roman, S. P. (2013).Disseminating evidence-based care into practice. Population healthmanagement, 16(4), 227-234.

Fisher, E. S., Shortell, S. M., Kreindler, S. A., Van Citters, A. D.,&amp Larson, B. K. (2012). A framework for evaluating the formation,implementation, and performance of accountable care organizations.Health Affairs, 31(11), 2368-2378.

Harris, J. R. (2012). A framework for disseminating evidence-basedhealth promotion practices. Preventing chronic disease, 9.

Huskins, W. C., Huckabee, C. M., O`Grady, N. P., Murray, P.,Kopetskie, H., Zimmer, L., … &amp Wallace, D. (2011). Interventionto reduce transmission of resistant bacteria in intensive care. NewEngland Journal of Medicine, 364(15), 1407-1418.

Koff, M. D., Corwin, H. L., Beach, M. L., Surgenor, S. D., &ampLoftus, R. W. (2011). Reduction in ventilator associated pneumonia ina mixed intensive care unit after initiation of a novel hand hygieneprogram. Journal of critical care, 26(5), 489-495.

Lake, E. T., Hallowell, S. G., Kutney-Lee, A., Hatfield, L. A., DelGuidice, M., Boxer, B. A., … &amp Aiken, L. H. (2016). Higherquality of care and patient safety associated with better NICU workenvironments. Journal of nursing care quality, 31(1),24-32.

Marwati, T., Subiyanto, A. A., Mardikanto, T., Priyambodo, P.,Wibowo, M., &amp Qomariyah, N. (2016). The Impact of Surgical SiteInfection to the Health Care Cost. International Journal of PublicHealth Science (IJPHS), 5(2), 129-133.

Mathur, P. (2011). Hand hygiene: back to the basics of infectioncontrol. The Indian journal of medical research, 134(5),611.

Pincock, T., Bernstein, P., Warthman, S., &amp Holst, E. (2012).Bundling hand hygiene interventions and measurement to decreasehealth care–associated infections. American journal of infectioncontrol, 40(4), S18-S27.

Rocha, L. A., Nunes, M. J., &amp Gontijo Filho, P. P. (2012). Lowcompliance to handwashing program and high nosocomial infection in abrazilian hospital. Interdisciplinary perspectives on infectiousdiseases, 2012.

Rosenthal, V. D., Bijie, H., Maki, D. G., Mehta, Y., Apisarnthanarak,A., Medeiros, E. A., … &amp Martínez, M. D. R. G. (2012).International Nosocomial Infection Control Consortium (INICC) report,data summary of 36 countries, for 2004-2009. American journal ofinfection control, 40(5), 396-407.

Salama, M. F., Jamal, W. Y., Al Mousa, H., Al-AbdulGhani, K. A., &ampRotimi, V. O. (2013). The effect of hand hygiene compliance onhospital-acquired infections in an ICU setting in a Kuwaiti teachinghospital. Journal of infection and public health, 6(1),27-34.

Yeung, W. K., Tam, W. S. W., &amp Wong, T. W. (2011). Clusteredrandomized controlled trial of a hand hygiene intervention involvingpocket-sized containers of alcohol-based hand rub for the control ofinfections in long-term care facilities. Infection Control &ampHospital Epidemiology, 32(01), 67-76.

Appendix 1

Participant’s Questionnaire

The questionnaire helps in assessing the attitude of the participants of the project. It is administered to all the nurses and other health officers to make sure that they give the required response.

Score 0 for NO and 1 for YES.


1 Point


0 Points

  1. Do you use the alcohol-based hand gel frequently?



  1. Are you often reminded to perform the hand hygiene?



  1. Do you believe that the hand hygiene is more appropriate in controlling the infections?



  1. Are the alcohol-based hand rubs placed at specific points of care within the hospital?





Appendix 2

Attitude of the Participants in the Project

Pre- and Post-Test

  1. Are the hand hygiene posters effective in reminding the participants?



  1. Are you often too busy to use the hand rubs or you just ignore them?



  1. Are the peers the one that remind you of using the hand hygiene?



  1. Do the patient, peers and managers consider the hand hygiene as an important factor?



  1. Do you follow the recommended guidelines while using the hand hygiene technique?



  1. Does each nurse access the simple instructions needed in using the hand rubs?