Running Head: EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

The Use of the Core Elements in Educating Healthcare Professionals on Hand-Hygiene

Angela Voto
Northeastern University
ENGW 3306 Christen Enos
September 26, 2014

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

The Use of the Core Elements in Educating Healthcare Professionals on Hand-Hygiene

One of the main causes of prolonged hospital stays in the United States, contributing to
an estimated annual economic burden of 6.5 billion dollars is hospital acquired infections (HAIs)
(Ciofi Delgi Atti, 2011). Proper hand-hygiene is one of the most effective and least expensive
ways healthcare providers can help to reduce the rate of hospital acquired infections (Hamilton &
Crane, 2014). Although many healthcare professionals are aware of the key role that handhygiene can play in decreasing HAIs, there continues to be an issue with sustained compliance in
the hospital setting. The educational document Hand-Hygiene by Persis Hamilton from Wild
Iris Medical Education, a privately-owned company that provides healthcare professionals a
continuing education, aims to enable healthcare professionals to understand the rationale for
hand hygiene, recognize current hand hygiene products, and enhance adherence to recommended
hand washing guidelines (Hamilton & Crane, 2014). The author of this document takes many
steps in order to ensure that the discourse community is provided with a proper understanding of
hand-hygiene and its importance in decreasing HAIs.
As discussed above, the purpose of this document is to educate healthcare professionals
on the importance of proper hand-hygiene. The author aims to educate the audience through four
core learning objectives including the ability to state the relationship between hand hygiene and
the prevention of healthcare-associated infections, discuss the antiseptic effectiveness and safety
of common hand hygiene products, explain the steps involved in effective hand washing, and
identify factors that affect adherence to hand washing protocols (Hamilton & Crane, 2014).
Although this document is part of a paid course, the authors main motivation for writing this
educational text is not to make a profit. In fact, it is possible to take the course and complete the
exam without paying, however in order to get a certificate of completion one must register and

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

pay for the course. Rather than the desire for revenue, the author offers a certificate of
completion as an incentive to the audience to do well on the exam. The audience could desire to
give the certificate to their supervisor or manager to signify that they have completed the course.
The author can ensure that the purpose of the document is successfully achieved when the reader
completes and passes the exam (passed being 70% or better) at the end of the document,
verifying the reader has gained the correct understanding of the information.
At the start of the document, the author clearly states in the course objectives that the
intended audience of the course is healthcare professionals. Before even beginning the program,
the audience most likely has at least some, if not a great deal of knowledge in the importance of
proper hand-hygiene because this is a key topic of interest within the medical field. This prior
knowledge could cause the audience to be bias toward the document because they think that they
are already experts on this topic. The audience needs to take this course with an open-mind in
order to benefit from this document. The audience must have a want or desire to effectively learn
additional information provided about the topic of hand hygiene that they may not have
knowledge of yet. This information is essential in providing competent care to patients thus
keeping with the values and principles of healthcare professionals.
In order to tailor the document to the already knowledgeable audience, the author
provides many statistical values and facts as well as several forms of clinical evidence or
evidence-based practice that helps to reiterate the importance of the proper hand-hygiene
techniques and protocols. For example, the author provides the audience with evidence to
demonstrate how when nurses are understaffed they tend to cut corners and "in 2004, California
became the first state to pass legislation mandating nurse-patient ratios, as follows: 1 nurse to 2
critical care patients in units such as intensive care, 1 nurse to 3 patients in step-down units, and

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

1 nurse to 4 patients in specialty units" (Hamilton & Crane, 2014). The audience can
significantly benefit from repetition of various factual information and real-life examples in
order to increase their adherence of hand-hygiene within the hospital.
The design of the course is extremely 'user friendly' as the author clearly lays out the
instructions, course completion time, information about the company, course learning objectives,
and disclosure information on the first page of the document. This helps determine the intended
audience for the document and summarize the information in an organized format. The author
draws the audiences attention to the course instructions and passing requirements by choosing a
green font rather than the black font used for the remainder of the document. When taking this
course, the healthcare professional can easily find the course synopsis which has been placed in a
separate textbox to stand out from the rest of the document. The synopsis is bulleted with links to
each section of the course including: A History of Hand washing, Skin Physiology and Normal
Skin Flora, Transmission of Pathogens by Way of the Hands, Hand Hygiene Products, Aseptic
Hand Cleansing, Skin Reactions Related to Hand Hygiene, Adherence to Hand Hygiene
Practices, Conclusion, Resources, and References (Hamilton & Crane, 2014). This allows the
reader to easily navigate around the document and skipped to the various sections and
subsections if desired.
The author uses the capitalization of entire words, bold letters, and/or italics to emphasis
important words or definitions such as hand-hygiene, hand sanitizer, Clostridium difficile,
Staphylococcus aureus, antiseptic, disinfectant, soap and water, and alcohol-based hand rub
(Hamilton & Crane, 2014). This helps the audience focus on important key terms and make it a
point to remember these terms for the exam. In addition, bullet points are often used when
comparing terms that are related such as the layers of the skin (epidermis, dermis, and

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

hypodermis). An image of the layers of the skin accompanies the text in order to help the reader
envision its function and structure. By communicating the information in various forms, using
visuals and text, the author allows for the education of a broader audience because not all people
learn effectively in the same manner.
The writing style of the document is geared toward professionals with a background in
healthcare and prior knowledge of anatomical and medical terminology. When describing the
various steps of proper hand washing, the author uses words such as dorsum rather than just
hand. By inserting relevant case studies throughout the document, the author helps the audience
better relate to the information. The audience is able to envision this information being put to use
in a positive and effective way within the hospital setting and as a result will perceive the
information as being more important. The use of real-life situations will help the audience relate
to the information on a more personal level and therefore they will be able to see how this
information pertains to their every day professional lives.
The author writes this article in a way that speaks to the audience, using pronouns like
"your" and "my" so the audience feels engaged in the document. In explaining when it is
important for healthcare providers to perform hand-hygiene, the author creates an easy to follow
chart of "my five moments for hand-hygiene". The author states when and why it is important to
wash your hands by using numbers and bold font to emphasis these significant moments. For
example, "1. Before patient contact: clean your hands before touching a patient when
approaching him or her. Why? To protect the patient against harmful germs carried on your
hands. 2. Before an aseptic task: Clean your hands immediately before any aseptic task. Why?
To protect the patient against harmful germs, including the patient's own germs (Hamilton &
Crane, 2014). After reading this document, the audience will easily be able to remember these

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

five key moments when hand washing is essential and therefore they will be more likely practice
proper hand hygiene in the clinical setting.
The authors tone remains objective and unbiased throughout the document. Rather than
providing a personal feelings, judgments, or opinions on the topic, the author uses factual
explanations such as various clinical studies in order to portray the shockingly low rates of
adherence to hand hygiene. The author notes that in one study of 2,834 observed opportunities
for hand hygiene, researchers found that the average adherence rate was a shockingly low 48%"
(Vissher & Wickett, 2012). The tone of the document remains neutral and the author does not
imply that healthcare providers themselves are at fault for these low adherence rates. The author
includes a section of a bulleted list on barriers to adherence that various professional groups have
undertaken studies to identify. These barriers include "inaccessible hand hygiene supplies, skin
irritation caused by hand hygiene agents, insufficient time for hand hygiene, and high workload
and understaffing" (Hamilton & Crane, 2014). In including these barriers, the author empathizes
with the audience and is mindful of the obstacles that exist in a real-life healthcare setting. This
prevents the audience from feeling as though they are being punished or attacked on this subject
and therefore they will be more likely to voluntarily participate in the program. In addition, this
helps to capture a greater audience such as managers or additional personnel whose focus is on
creating and implementing hospital-wide protocols to overcome these barriers and increase
adherence rates.
All in all, the author effectively uses the three core elements of purpose, audience, and
persona to educate healthcare professionals on proper hand hygiene and its effect on reducing
infection and transmission of microorganisms from person to person (Hamilton & Crane, 2014).
This document is used as an educational tool to communicate facts and evidence to healthcare

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

professionals and establish techniques to increase their adherence to hand hygiene policies.
Throughout the document the author uses resources such as the Association for Professionals in
Infection Control and Epidemiology (APIC), Association of Perioperative Registered Nurses
(AORN), Centers for Disease Control (CDC), and the World Health Organization (WHO) in
order to provide reliable and factual data about this topic. The author presents the information in
a professional and organized manner using strategic word choice, sentence structure, and
formatting options to ensure the success of the document and proper education of the audience.
The information provided throughout the document is consistent with the wants and needs of the
audience as well as their values and principles. By being educated on the importance of hand
hygiene as well as proper hand washing techniques, healthcare professionals can strive to
practice by these values and provide their patients with the best possible healthcare.

EDUCATING HEALTHCARE PROFESSIONALS ON HAND-HYGIENE

Works Cited
Ciofi Delgi Atti, M. L. (2011, June 13). Healthcare workers and parents perceptions of
measures for improving adherence to hand-hygiene. Website:
http://www.biomedcentral.com/bmcpublichealth/about
Hamilton, P., & Crane, L. (2014). Hand Hygiene. Retrieved September 12, 2014, from
http://www.nursingceu.com/courses/467/index_nceu.html
Vissher MO & Wickett RR. (2012). Hand hygiene compliance and irritant dermatitis: a
juxtaposition of healthcare issues. International Journal of Cosmetic Science, 34, 40215.
doi:10.1111/j.14682494.2012.00733.x.