Effectiveness of Timing for Hand Washing With Soap and Water in Reducing the Germs among Nursing Students in Selected Hospital at Jagdalpur, Bastar C.G. 2015

 

Ms. Annu Patel¹, Ms. Manjulata Kanwar¹, Ms. Premarani Rana¹, Mrs. SapnaThakur², Mrs. Smita Jha³

¹Students of Basic B.SC. Nursing 4^th Year, Government College of Nursing, Jagdalpur, Bastar, C.G.

²Principal, Government College of Nursing, Jagdalpur, Bastar, C.G.

³H.O.D. of Nursing Research, Government College of Nursing, Jagdalpur, Bastar, C.G.

 

ABSTRACT:

BACK GROUND OF STUDY: Hand Hygiene is the single most effective way to prevent nosocomial infections with correct timing and technique. The centers for Disease Control and Prevention (CDC) has stated: “It is well documented that one of the most important measures for preventing the spread of pathogens is effective hand washing. Dirty hands can lead to a sick patient even if the doctor of nurse touches only a bed rail or a chair in the room, said Rosalie Weak land, director of quality improvement for the association. Effective timing of hand washing with soap and water are depends upon institution protocol. The goal of the study is to analysis the effective timing of hand washing with soap and water among following timing, According to NACO Guideline effective timings is 20 sec, In 20 central Ohio hospital council, is 15 sec, and In Trained nurses association of India; fundamental of nursing a procedure Manual suggested 10 seconds of vigorous. METHODOLOGY: Evaluative research approach and quasi experimental research design. Conveniently 75 Samples of Government Hospital, Jagdalpur, were divided into three Experimental groups I, II and III. Observed hand washing for Group I- 10 seconds, Group II - 15 seconds and Group III- 20 Seconds. Each group was consisting of 25 student’s sample. Samples were trained, by the researcher, for six steps of hand washing. After proper training of hand washing, students were instructed to do the bed making of patients. Culture swabs were taken with strict sterile technique in different areas of hands especially between fingers just after bed making. Growths of micro-organisms were analyzed by using Descriptive and inferential statistics. RESULT:  frequency, percentage t test and f test were calculated. The   mean of experimental group I is 8.64, experimental group II is 7.52, and experimental group III is 8.2 calculated, t value were t₂₄=12, t₂₄=9.4 and t₂₄=10.6 for group E1, E2 and E3 respectively which is higher than the Table value at the df 24 and 0.05 level is 1.711. Hence null hypothesis is rejected. It means that all timing of hand washing is significantly effective in reducing the growth of germs. at the df 24 and 0.05 level is 1.711, and f test shows there is no significant difference in timing of hand washing with soap and water in reduction of germs. CONCLUSION: All timing of hand washing with soap and water that is 10 seconds, 15 seconds and 20 seconds are equally effective in reduction of germs. It is recommended that as per the time feasibility of health workers, anyone effective timing of hand washing, can be performed before and after each procedure.

 

 

INTRODUCTION:

Proper hand washing in hospitals is powerful tool against potentially deadly infections. Too often, it doesn’t happen as it should.

 

Numerous studies document the pivotal role of healthcare workers’ (HCWs) hands in the propagation of micro-organisms within the healthcare environment and ultimately to patients, HCWs contaminate their hands by touching the environment of patients’ skin during routine care activities, sometimes even despite glove use. It has been shown that organisms are capable of surviving on HCWs’ hands for at least several minutes following contamination. Thus, if hand hygiene practices suboptimal, microbial colonization is more easily established and ∕or direct transmission to patient or a fomite in direct contact with the patient may occur.

 

Dirty hands can lead to a sick patient even if the doctor of nurse touches only a bed rail or a chair in the room, said Rosalie Weak land, director of quality improvement for the association.

 

When hands aren’t washed, “we feel that potentially everything in the room is contaminated,” she said.

“But overall, hand- washing is not about spending big bucks. It’s about creating habit that sticks.”

 

NEED OF THE STUDY:

Medical errors and nosocomial infection are among the leading causes of death in the United States (IOM, 2001). Medical errors and nosocomial infection each kill more Americans than AIDS, breast cancer, of automobile accidents (IOM, 2001). Preventable errors in U.S. hospitals kill from 44’000-98’000 patients per year (IOM, 2000).

 

Hand Hygiene is the single most effective way to prevent nosocomial infections with correct timing and technique. The centres for Disease Control and Prevention (CDC) has stated: “It is well documented that one of the most important measures for preventing the spread of pathogens is effective hand washing.”

According to NACO Guideline effective timings of hand washing with soap and water is 20 sec. In20 central Ohio hospital council, better hand hygiene with soap and water defined as washing for 15 sec before and after each patient contact. In Trained nurses association of India; fundamental of nursing a procedure Manual  suggested 10 seconds of vigorous  hand washing is sufficient to kill the germs from the hand.

 

PROBLEM STATEMENT OF THE STUDY:

A quasi experimental study to assess the effectiveness of different time of hand washing with soap and water in reducing the germ among nursing students in selected hospital at Jagdalpur, Baster, C.G.2015.

 

OBJECTIVES:

1.      Assess the preinterventional growth of germs in experimental group beforehand wash.

2.      Implement the hand washing of difference timing (10, 15, and 20 seconds) with soap and water in all experimental groups.

3.      Assess the post interventional growth of germs in hand among experimental groups.

4.      Compare and evaluate the effectiveness of timing of hand washing (10, 15, and 20 seconds) among experimental groups.

 

HYPOTHESIS:

H1:- there will be significant reduction of growth of germs after hand washing.

H2:- there will be significant difference in timing of hand washing with soap and water reducing germs.

 

METHODOLOGY:

Research approach: evaluator research approach is used for research.

Research design: Quasi experimental research deign. Factorial research design often used by scientist in which wishing to understand the effect of two or more independent variable upon a single dependent variable.

 

 

 

E1- pre implementation cultural swab                   intervention                  post implementation cultural

                                                                                                     swab

                                                                          (10 sec. Hand washing)

 

E2- pre implementation cultural swab                   intervention            post implementation cultural

                                                                                                                        swab

                                                                          (15 sec. Hand washing)

 

E3- pre implementation cultural swab                      intervention             post implementation cultural

                                                                                                                           swab

                                                                          (20 sec. Hand washing)

SETTING:

Study is conducted in male medical ward of Maharani Hospital at Jagdalpur.

 

POPULATION:

Population for the study consist of all nursing students posted in wards.

 

SAMPLE:

Sample comprised of total 75 students of nursing who are working in the male medical ward of Maharani Hospital at Jagdalpur.

 

75 students were divided in the three experimental groups. Each group was consisting of 25 students sample were selected according to inclusion criteria.

 

SAMPLING TECHNIQUE:

Convenient sampling technique was used. Students of nursing who are posted and available at the time of data collection were used for the study.

 

DATA COLLECTION:

After taking permission from Joint Director cum Superintendent Study was started in Male Medical Ward. Nursing students of different nursing colleges and schools who are posted in the ward in all shifts were selected as sample. Samples were trained by the researcher before hand, for six steps of hand washing. After proper training of hand washing, students were instructed to do the bed making of patients. Culture swabs were taken with strict sterile technique in different areas of hands especially between fingers just after bed making.

 

Samples were instructed to do hand washing with lifebuoy soap and water. After air drying hands again culture swab was taken and send to microbiology lab for test.

 

Experimental group I, experimental group II and experimental group III were doing hand washing for 10 seconds, 15 seconds and 20 seconds respectively.

 

RESULT:

The frequency and percentage distribution of demographic variable of nursing students revealed that :1) Most of the students 50% were in the age group of 16-20 years 2) Most of the student 50 (67%) belongs to Government College of Nursing Jagdalpur 3)Most of the students were belong to first year that is 50 (67%).

 

 

 

 

 

TABLE 1. DISCRIPTION OF SAMPLE CHARACTERISTICS:                      n=75

S. NO.	SOCIODEMOGRAPHIC VARIABLES	FREQUENCY	(%)
1.	Age (in year): a)      16-20 b)      21-25 c)       26-30 d)      31-35	50 20 05 NIL	67 26 07 NIL
2.	Educational level: a)       Nursing I year b)       Nursing II year c)       Nursing III year d)       Nursing IV year	50 20 05 NIL	67 26 07 NIL
3.	Name of institution: a)      Government College of Nursing Jagdalpur b)      Bodhany devi College of Nursing Jagdalpur c)       Adeshwar College of Nursing Jagdalpur d)      Government School of Nursing Jagdalpur	50   10   10   05	67   13   13   07

 

 

 

TABLE 2: Mean, standard deviation, standard deviation error in before hand washing (BHW) and after hand washing (AHW) n=25

Group		Mean	Sd	SEd	t-value	Significant
I	BHW	8.64	3.74	0.72	12	Highly significant
	AHW	0	0
II	BHW	7.52	4.06	.78	9.4	Highly significant
	AHW	0	0
III	BHW	8.2	3.89	0.77	10.6	Highly significant
	AHW	0	0

 

 

 

H01: there will be no significant reduction of growth of germ after hand washing:

Data presented in table 2 depicts that mean of experimental group I is 8.64, experimental group II is 7.52, and experimental group III is 8.2 calculated t value were t₂₄=12, t₂₄=9.4 and t₂₄=10.6 for group E1, E2 and E3 respectively which is higher than the Table value at the df 24 and 0.05 level is 1.711. Hence null hypothesis is rejected. It means that all timing of hand washing is significantly effective in reducing the growth of germs.

 

 

 

 

 

H02: there will be no significance difference in timing of hand washing with soap and water in reduction of germs.

Square of variable	df	Sum of square	Mean of sum of square	F ratio
Between the group	3-1=2	15.92	7.96	0.481
Within the group	75-3=72	1190	16.52
Total	75-1=74

  

Tabulated f value for Horizontal (df=2) and vertical of (df=72) at the 0.05 level of significance. The calculated F value (f₇₄=0.481 at df 74) is lesser than tabulated f value at 0.05 level that is 2.37. Hence null hypothesis is not rejected. If means that there is no significant difference in timing of hand washing with soap and water in reduction of germs. So it is proved that all timing that are 10 seconds, 15 seconds and 20 seconds are showing same effect in reduction of germs.

 

RECOMMENDATION:

On the Basis of the findings of this study, it is recommended that:

1.       A study to assess the knowledge and practice of hand washing among all health members in various hospitals.

2.       A same study may be conducted at community area to increase awareness about effective timing of hand washing.

3.       This study can also be replicate in large sample.

 

CONCLUSION:

All three timings of hand washing that is 10 s, 15s, and 20s are showing the same effect in reducing the growth of germs.

 

REFERENCES:

1.       American’s Hand Hygiene Habits) SCA, KRC Research global and hygiene company 2012.

2.       Clean care is safer care programmer .world health organization.2015may 5.

3.       Erb’s, Koziers Text Book Of Fundamental Of Nursing. Concepts process and practice 8^th ed. Dorling Kinders India Private Limited; 2008.

4.       Grayson Lindsay M., the National hand hygiene initiative., Hand hygiene Australia; 2015 @Hand hygiene Aus (twitter+ face book.

5.       NACO Guideline effective timing of hand washing. NACO, 2012.

6.       Rodak S.; Better hand hygiene.IN 20 central Ohio hospital council 2013, Jan; 11.

7.       TNAI Nurses association Manuals of nursing India fifth edition New Delhi: Arawali Printers And Publishers Pvt.Ltd; 2011.

 

 

 

 

Received on 26.05.2016           Modified on 22.06.2016

Accepted on 30.06.2016           © A&V Publication all right reserved