such as vancomycin-resistant Enterococcus (VRE) , Streptococccus pyogenes, and methicillin- resistant Staphylococcus aureus (MRSA), can be spread through the hands of healthcare workers related to poor hand hygiene (Neo et al., 2016). Evidence supporting proper hand hygiene and the reduction of HAIs has been available for over two centuries, compliance continues to be low, and most efforts for improvement fail (Kirkland et al., 2012). Implications for Practice One of the most effective and most simple ways to help prevent HAIs promote positive patient outcomes, optimal healthcare, and to decrease antimicrobial resistance is hand washing. (APIC, 2015). Implementing a strong hand hygiene program will provide a great base in which to build on for reaching the set goals. The evidence listed above supports the use of a multimodal intervention that will improve hand hygiene compliance among employees of BEMC. In order to provide a safe environment for all patients, families, members of the community and staff, regular hand hygiene practices are critical. The “My 5 Moments for Hand Hygiene” from The World Health Organization (2018), is a very recognizable framework in determining key moments for hand hygiene among staff. “These include: washing before and after patient care and before any aseptic procedures, after body fluid exposure, and after contact with patient surroundings” (WHO, 2018, p. 1). In performing these acts, healthcare staff can reduce the risk of HAIs. Section C: Literature Support Review of the Literature
11 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL A review of the literature was done to determine the best approaches to improve compliance with hand hygiene practices among healthcare professionals. The aim was to answer two questions. First, what interventions can improve compliance with hand hygiene practices among healthcare professionals? Second, which combination of interventions are best at increasing compliance and sustainability of routine hand hygiene practices? Review Method The Fineout-Overholt, et al., (2010) Hierarchy of Evidence guided the literature review (See Appendix B). A comprehensive electronic search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) ProQuest and Academic Search was completed. The search was limited to reviews for the time period of 2013-2018, published in English with highest levels of evidence available. Keywords were handwashing, adherence, compliance and multimodal. Inclusions were healthcare staff employed in an acute care setting including: nurses, physicians, advanced practice providers, emergency room techs, radiology techs, nurse assistants, environmental services, registration personnel and administrative staff. Also included were reviews involving any multi-modal interventions improving hand hygiene compliance, comparison before and after implementation of interventions, as well as incidences of HAIs as a result of interventions. Exclusions were articles that did not have a multimodal intervention, settings not involving acute care such as schools, primary care clinics or community centers. Additional
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- The Land, HAIs, BEMC