Hand hygiene compliance: is there a theory-practice-ethics gap?
- 27 September 2012
- journal article
- Published by Mark Allen Group in British Journal of Nursing
- Vol. 21 (17), 1011-1014
- https://doi.org/10.12968/bjon.2012.21.17.1011
Abstract
Practice is usually based on tradition, rituals and outdated information; there is often an additional gap between theoretical knowledge and its application in practice. This theory-practice gap has long existed ( Allmark, 1995 ; Hewison et al, 1996 ). It often arises when theory is ignored because it is seen as idealistic and impractical, even if it is practical and beneficial. Most research relating to the lack of integration between theory and practice has concluded that environmental factors are responsible and will affect learning and practice outcomes. The author believes an additional dimension of ethics is required to bridge the gap between theory and practice. This would be a moral obligation to ensure theory and practice are integrated. To implement new practices effectively, healthcare practitioners must deem these practices worthwhile and relevant to their role. This introduces a new concept that the author calls the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when examining some of the unacceptable outcomes in healthcare practice ( Mortell, 2009 ). The literature suggests that there is a crisis of ethics where theory and practice integrate, and practitioners are failing to fulfil their duty as providers of healthcare and as patient advocates. This article examines the theory-practice-ethics gap when applied to hand hygiene. Non-compliance exists in hand hygiene among practitioners, which may increase patient mortality and morbidity rates, and raise healthcare costs. Infection prevention and control programmes to improve hand hygiene among staff include: ongoing education and training; easy access to facilities such as wash basins; antiseptic/alcohol handgels that are convenient, effective, and skin- and user-friendly; and organisational recognition and support for clinicians in hand washing and handgel practices. Yet these all appear to have failed to achieve the required and desired compliance in hand hygiene.Keywords
This publication has 21 references indexed in Scilit:
- Does hand hygiene compliance among health care workers change when patients are in contact precaution rooms in ICUs?American Journal of Infection Control, 2010
- Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007Infection Control & Hospital Epidemiology, 2008
- Nosocomial infectionsContinuing Education in Anaesthesia Critical Care & Pain, 2005
- Why don't doctors and nurses wash their hands?Infection Control & Hospital Epidemiology, 2001
- Lapses in measures recommended for preventing hospital-acquired infectionJournal of Hospital Infection, 2001
- It Is Time for Action: Improving Hand Hygiene in HospitalsAnnals of Internal Medicine, 1999
- The theory‐practice gap in nursing: a new dimensionJournal of Advanced Nursing, 1996
- Selected Aspects of the Socioeconomic Impact of Nosocomial Infections: Morbidity, Mortality, Cost, and PreventionInfection Control & Hospital Epidemiology, 1996
- A classical view of the theory‐practice gap in nursingJournal of Advanced Nursing, 1995
- Handwashing—the Semmelweis lesson forgotten?The Lancet, 1994