Identifying outcomes Paper

Hand Washing vs. Hand Sanitizer
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Abstract
Hand hygiene is a clinical measure for reducing the transmission of nosocomial pathogens. Hospitals face a challenge in adherence and compliance of hand hygiene which currently remains a major issue in the hospital environment. With the increased spread of information on the epidemiology of hand hygiene and compliance, improved approaches are recommended; policies and guidelines for improved standards have been revisited. This study will implement the Donabedian’s theory of quality health care evaluation for the outcome. Donabedian’s theory is ideal in this study because it gives a particular focus to practical strategies for raising the awareness of the patients as the primary clients. In addition, the theory guides in creating frameworks that will result in satisfaction based on the outcome of the proposed change. As such, factors to be addressed in this study will include; the effectiveness of advanced and improved hand washing procedure, supportive strategies in the nursing strategies and the recommendation for change (Grove, Burns, & Gray, 2014).
Hand Washing vs. Sanitizer
Lack of information and knowledge of the effectiveness of hand washing procedures without any form of additional properties on the type of detergent is a cause for compliance without outcomes. Further, the barrier to compliance may include skin irritation due to detergents that damage the skin. Hence, this will discourage the process of compliance for the hand washing procedure.

Hand sanitizers are incorporate properties that protect the skin and minimize shedding of microbial.
Improved Measures in Sanitizers
Hand sanitizers increase the possibility of rapidly minimizing infection that patients are exposed to. Effective support and better self-care along with supportive health care providers ensure that the existing infections have been minimized and the spread of infection is stopped before it occurs (Cohen, Saiman, Cimiotti & Larson, 2003). However, the practical nature of care is surrounded by time constraints amid a multitude of responsibilities. Hence, this increases the chances of reduced compliance of hand washing compared to the use of sanitizers.
Continued compliance is maintained, and the cost of care is reduced due to a minimized rate of infection. However, continued responsibility is in the hands of the patient and the care givers in enhancing top level hygienic standards. With adherence to the standard measure of improvement, the patients will spend less time in the health care facilities hence reducing the cost and resources that are used in the prolonged status of care. Improved technology applied to enhance the method of hand washing is effective in conduction self-care (McArdle, Lee, Gibb & Walsh, 2006).
Recommendation to Change
Changes in the areas of hygiene that are given little attention are taking place affecting the social and health care set-ups. Hand washing hygiene is currently receiving increased attention though adherence to the practice is still low. Various aspects of noncompliance are now clear and proposed corrective actions have been proposed. The use of hand sanitizers compared to hand washing with soap and water is increasingly being recommended as the current standard of care. The system change is to be applied in health care facilities as well s in the social settings (Pittet, 2003).
To enhance compliance the health care workers are required to participate as part of the multimodal approach, their duty is to motivate, educate and modify the current hygienic behavior. Adherence to improvement will reduce infection and minimize the spread of any infection. In hospital set-up, hand sanitizers replace the role of the conventional surgical hand washing with antiseptic soap and distilled water in preparation for a surgical procedure (Scheithaue et al., 2009). Technological advancement and improvement play a significant role in the process of change. Hence, the improvement of the hand washing procedure is a positive application to nursing practice and maintenance of health care practices.
Conclusion
The factor of change in the standard of hand washing is a measure to increase the adherence to compliance of hand hygiene. Hand washing was limited by time constraints in daily nursing activities. However, the use of sanitizers increases the factor of compliance of hand washing procedures. The proposal for change has achieved positive feedback along with practical aspects in patient satisfaction. Continued practice and education will increase knowledge and compliance which will mean minimized infections and the cost incurred in health care. The factor of change will ensure future improvement in hand hygiene in the hospital and social set-up.
References
Cohen, B., Saiman, L., Cimiotti, J., & Larson, E. (2003). Factors associated with hand hygiene practices in two neonatal intensive care units. The Pediatric infectious disease journal, 22(6), 494.
Grove, S. K., Burns, N., & Gray, J. R. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.
McArdle, F. I., Lee, R. J., Gibb, A. P., & Walsh, T. S. (2006). How much time is needed for hand hygiene in intensive care? A prospective trained observer study of rates of contact between healthcare workers and intensive care patients. Journal of Hospital Infection, 62(3), 304-310.
Pittet, D. (2003). Hand hygiene: improved standards and practice for hospital care. Current opinion in infectious diseases, 16(4), 327-335.
Scheithauer, S., Haefner, H., Schwanz, T., Schulze-Steinen, H., Schiefer, J., Koch, A., … & Lemmen, S. W. (2009). Compliance with hand hygiene on surgical, medical, and neurologic intensive care units: direct observation versus calculated disinfectant usage. American journal of infection control, 37(10), 835-841.