Effective methods of promoting hand hygiene to reduce hospital acquired infections: A literature review

Aim: A literature review aimed to explore the most effective methods of promoting hand hygiene in nursing to reduce the prevalence of hospital acquired infections (HAIs). Methodology: A literature search was conducted using AMED, British Education Index, CINAHL Ultimate, ERIC and MEDLINE with the search terms “hand hygiene, hospital acquired infection, reduction, and promotion” between 2014 and 2024. A PICO framework helped to create a search hypothesis and a PRISMA flowchart used. The search was later repeated between 2017 and 2024 to be relevant post Covid 19 pandemic. Results: n=9 research studies were retrieved, reduced to n=6. The research studies were critically appraised to identify themes and relevant discussion. Findings: The reviewed research studies had a variety of methodologies used, sample size and time periods. Three key themes were first, education and knowledge; second, direct observation, and third, reminders/ prompts. All research studies demonstrated a correlation between promoting hand hygiene and a reduction in hospital acquired infections. Discussion: The cost of HAIs was an issue in terms of a negative effect on hospital resources (beds, staffing costs, equipment) and positive patient outcomes. Despite WHO (2020) and organisational guidelines of best practice, education and training, hand hygiene frequency had improved at the beginning of the Covid 19 pandemic, with healthcare staff being key to reduce HAIs but hand hygiene later became less observed due to high staff workload and burnout. The research findings reinforce WHO guidelines, and indicate a need for regular training, reminders, and updates in clinical practice to promote hand hygiene to reduce the incidence of HAIs. Conclusion: HAIs have a negative impact on patients’ treatment outcomes, cost, and resource implications and despite WHO (2020) guidelines, continue to have a negative impact on patients’ health outcomes. Nurses dealing with a high workload and burnout are at risk of forgetting the importance of hand hygiene and evidence-based practice, yet hand hygiene is most cost-effective method of reducing HAIs.