RUA Group

The role of hand hygiene in the reduction of C. Diff infections Presented by: Abigail Rye, Aissata Diallo, Lydia-Tilacious Otoo, Nicole Bates, Olivia Boyster, and Tracey Hooper

NR 449: Evidence Based Practice

Professor Mary Pomietlo

Hand Hygiene Compliance and Its Impact on Nursing Practice

• Clostridium difficile infection (CDI) is a major health care-associated infection (HAI) in the united states (Yankee et al., 2021)

• CDC states that C. diff causes diarrhea, and can result in serious complications

o Dehydration, colitis, sepsis, and even death

• According to the CDC 5000,000 cases and 29,000 death annually

• 1 out of 31 hospitalized clients will acquire an HAI (Banks & Phillips, 2021)

• Adherence to hand hygiene standards by healthcare staff is a curial challenge

• PICOT: "….."

The Research Process

• Clear Picot Question established search

• Strong search terms helped discover relevant studies

• Chamberlain University Library provided relevant high-quality results

• Each group member found 2 strong primary resources

• Group matrix facilitated organization of found information

• Time in PICOT question limited results relevant

• Availability of randomized controlled trials limited due to ethical/practical constraints

• Manny non-primary sources, outdated sources, and lack of full text articles posed barriers in search process

What went well Barriers encountered

What is still needed

• Evaluation of long-term data on sustainability

• More research specifically geared tord nurses

• Studies comparing compliance- improvement strategies

Correlates research findings to identified clinical issue.

Summarizes validity of qualitative and quantitative evidence.

Findings are clearly identified.

Recommends practice change with measurable outcomes and addresses feasibility issues.

Suggestions for implementation.

Conclusion of content findings.

References Banks, M., & Phillips, A. B. (2021). Evaluating the effect of automated hand hygiene technology on compliance and C. difficile rates in a long-term acute care hospital.American Journal of Infection Control, 49(6), 727–732. https://doi.org/10.1016/j.ajic.2020.10.018Links to an external site.

Boyce, J. M. (2024). Hand and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp. Antimicrobial Resistance & Infection Control, 13(1), Article 110. https://doi.org/10.1186/s13756-024-01461-xLinks to an external site.

Carling, P. C., O’Hara, L. M., Harris, A. D., & Olmsted, R. (2023). Mitigating hospital-onset Clostridioides difficile: The impact of an optimized environmental hygiene program in eight hospitals. Infection Control & Hospital Epidemiology, 44(3), 440–446. https://doi.org/10.1017/ice.2022.84

Comparcini, D., Simonetti, V., Segala, F. V., Di Gennaro, F., Bavaro, D. F., Pompeo, M. A., Saracino, A., & Cicolini, G. (2023). Nurses’ Knowledge, Attitudes and Practices on the Management of Clostridioides difficile Infection: A Cross-Sectional Study.Antibiotics (Basel), 12(3), 529. https://doi.org/10.3390/antibiotics12030529Links to an external site.

Durant, D. J., Willis, L., & Duvall, S. (2020). Adoption of electronic hand hygiene monitoring systems in New York state hospitals and the associated impact on hospital-acquired C. difficile infection rates.American Journal of Infection Control, 0(0). https://doi.org/10.1016/j.ajic.2020.04.005Links to an external site.

Kaushik, A., Beal, K., & Gupta, S. (2023). 689. Significant Improvement in Hand Hygiene Compliance and Decline in Clostridioides difficile Infections with Implementation of Infection Prevention Interventions. Open Forum Infectious Diseases, 10(Supplement_2). https://doi.org/10.1093/ofid/ofad500.751Links to an external site.

Kiersnowska, Z. M., Lemiech-Mirowska, E., Semczuk, K., Michałkiewicz, M., Sierocka, A., & Marczak, M. (2021). Level of Knowledge of Medical Staff on the Basis of the Survey in Terms of Risk Management, Associated with Clostridioides difficile Infections.International Journal of Environmental Research and Public Health, 18(13), 7060. https://doi.org/10.3390/ijerph18137060

References Lee, E. H., Lee, H. S., Lee, K. H., Song, Y. G., & Han, S. H. (2023). Potential causal effect of contact precautions and isolation on Clostridioides difficile infection in the hyperendemic setting: Interrupted time-series analyses before and after implementation. Journal of Microbiology, Immunology and Infection, 56(5), 1054–1063. https://doi.org/10.1016/j.jmii.2023.06.003Links to an external site.

Lev, V., Anbarchian, T., Yao, H., Bhat, A., Britt, P., & Shieh, L. (2024). Health care–associated Clostridioides difficile infection: Learning the perspectives of health care workers to build successful strategies.American Journal of Infection Control, 52(3), 284–292. https://doi.org/10.1016/j.ajic.2023.08.008Links to an external site.

Panagiota, X., Chrysanthi, O., Chrysanthi, X., & Charalampos, P. (2025). Community-Acquired Clostridioides difficile Infection: The Fox Among the Chickens.International Journal of Molecular Sciences, 26(10), 4716. https://doi.org/10.3390/ijms26104716Links to an external site.

Prasad, P., Brown, L., Ma, S., McDavid, A., Rudmann, A., Lent, D., Reagan-Webster, P., Valcin, E. K., Graman, P., & Apostolakos, M. (2021). “If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection. Infection Control and Hospital Epidemiology, 42(11), 1351–1355. https://doi.org/10.1017/ice.2020.1422Links to an external site.

Yanke, E., Moriarty, H., Carayon, P., & Safdar, N. (2021). “The Invisible Staff”: A Qualitative Analysis of Environmental Service Workers’ Perceptions of the VA Clostridium difficile Prevention Bundle Using a Human Factors Engineering Approach. Journal of Patient Safety, 17(8), e806– e814. https://doi.org/10.1097/PTS.0000000000000500Links to an external site.

Zhang, S., Duan, J., Zhang, L., Liu, S., Meng, X., Peng, X., Liu, W., Wu, A., & Li, C. (2025). Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections.Antimicrobial Resistance and Infection Control, 14(1), 113. https://doi.org/10.1186/s13756-025-01616-4Links to an external site.