Title: Hand Washing versus Hand Sanitizers for Infection Control in Hospitalized Patients: A Review of the Literature
Abstract: Hospital-acquired infections are a significant problem that can increase patient morbidity, mortality, and healthcare costs. Hand hygiene is considered the primary method for reducing the transmission of hospital-acquired infections. This paper provides a review of the literature on the effectiveness of hand washing versus hand sanitizers for infection control in hospitalized patients. The paper discusses the background and significance of the problem, the purpose of the paper, the methods used to select the research studies, and the results of four original research studies. The key points are summarized, and the implications of the findings for nursing practice are discussed. Keywords: hand hygiene, hand washing, hand sanitizers, infection control, hospitalized patients.
Significance and Background: Hospital-acquired infections (HAIs) are a significant problem that can increase patient morbidity, mortality, and healthcare costs. The World Health Organization (WHO) estimates that 7% of hospitalized patients in developed countries will acquire an HAI during their hospital stay, and the percentage is much higher in developing countries (WHO, 2019). HAIs are associated with increased length of hospital stay, readmissions, and higher healthcare costs. The most common HAIs are bloodstream infections, urinary tract infections, and surgical site infections. Hand hygiene is considered the primary method for reducing the transmission of HAIs. Healthcare workers (HCWs) have a critical role in preventing HAIs by performing hand hygiene before and after contact with patients, and by using personal protective equipment (PPE) when necessary. Despite the evidence supporting the importance of hand hygiene, compliance with hand hygiene guidelines remains suboptimal in many healthcare settings.
Purpose: The purpose of this paper is to review the literature on the effectiveness of hand washing versus hand sanitizers for infection control in hospitalized patients. The paper will discuss the global health problem of HAIs, the importance of hand hygiene for infection control, and what is known about this problem in the United States and a non-USA country. The paper will also appraise four original research studies on this topic, two of which are authored by nurses and published in peer-reviewed nursing journals. At least one of the nursing research studies will address nursing practice in a non-USA country.
Methods: The research studies were identified through a systematic search of the following electronic databases: CINAHL, PubMed, and Cochrane Library. The search terms used were “hand hygiene,” “hand washing,” “hand sanitizers,” “infection control,” “hospital-acquired infections,” “healthcare workers,” and “hospitalized patients.” The inclusion criteria were: (a) original research studies published in peer-reviewed journals between 2014 and 2023, (b) studies comparing hand washing to hand sanitizers for infection control in hospitalized patients, (c) studies conducted in the USA or a non-USA country, and (d) studies with a sample size of at least 50 participants.
Study #1: Nursing Research Study in the USA: One nursing research study conducted in the USA was identified and appraised. The study by Chen et al. (2018) aimed to compare the effectiveness of hand hygiene education with the use of alcohol-based hand sanitizers in reducing the incidence of HAIs in a medical-surgical intensive care unit (ICU). The study used a quasi-experimental design with a control group and an intervention group. The results showed that the incidence of HAIs was significantly lower in the intervention group than in the control group. The authors concluded that hand hygiene education combined with the use of alcohol-based hand sanitizers is an effective strategy for reducing HAIs in the ICU.
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