Effectiveness of Hand Hygiene
The literature confirms HH is the single most effective measure to prevent HAIs. A structured patient-focused hand hygiene program provides an inexpensive and highly effective preventative measure against HAIs (Cheng et al., 2007; Gagne, Bedard, & Maziade, 2010; Schweon & Kirk, 2011). Patients’ hands may be contaminated from endogenous and exogenous sources. Additionally, the transmission of hand contamination between patient and HCP is dynamic and reciprocal (Banfield & Kerr, 2005). Hands may also be contaminated from the environment and vice versa. For example, gram-positive and gram-negative bacteria transfer from the fingertip to the lip was similar to transmission from hard surfaces to hands, demonstrating
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Neither the CDC (2002) nor the WHO (2009) addressed the role of patient HH. However, both the Society for Healthcare Epidemiology (SHEA) and the Association for Professionals in Infection Control and Epidemiology (APIC) guidelines suggested patient HH should be addressed. Landers et al. (2012) suggested nine moments for patient hand hygiene within acute care settings: 1) after toileting, 2) when returning to the room, 3) before oral intake, 4) when visibly soiled, 5) before touching non-intact skin or before an invasive procedure, 6) before dialysis, contact with indwelling devices, 7) after coughing or sneezing, 8) before and after visitor contact, and 9) when there is a concern if hands are clean. However, the unique challenges of LTCF s (providing care to a vulnerable population with limited resources) are less delineated (Schweon & Kirk, 2011). Furthermore, there is a lack of studies related to the patients’ hands serving as a reservoir or means of transmission and the effect of patient HH in reducing these risks. Since the best way to conduct a study around this topic is unknown, the proposed feasibility study will help determine the optimal ways to obtain the sample, measure variables, develop the best study materials, and have the most robust statistical