The effectiveness of Hand Washing Soap and water compared to Hand Sanitizer

The spread of various infectious diseases is often associated with contaminated hands or failure to observe hand and body hygiene. Proper cleaning of hands is critical in ensuring that the spread of germs such as viruses and bacteria that cause diseases is effectively prevented. Studies indicate that a majority of people around the world often fail to wash their hands adequately or frequently enough. Just about 16% of people observe hand hygiene wash their hands at the recommended time periods. Moreover, research has previously revealed that only about 80% of people observe hand hygiene implying that one in every five people rarely washes their hands ( Mathur, 2011). Many organizations that are committed to the implementation of maintenance of the practice of appropriate hand hygiene still encounter challenges of dealing with sections of their populations that have a habit of embracing practices that are inconsistent with their efforts. 

A hand sanitizer may be defined as a substance that is used in eliminating or decreasing the activity of infectious agents existing on hands. Hand sanitizers are often used as alternatives to soap and water in maintain hand hygiene. The information provided by the Centers for Disease Control and Prevention (CDC) indicates that one of the other options to soap and water method of washing hands us the use of alcohol-based hand sanitizer ( Mathur, 2011). To that extent, the purpose of this research is to determine the effectiveness of using soap and water compared to hand sanitizer as a means of observing hand hygiene. In this regard, the independent variables are washing soap and water as well as hand sanitizer whereas the dependent variable is the effectiveness of hand washing. The basis of this research is a question namely; which one is more effective when hand washing using soap and water is compared to using a hand sanitizer? 

Theoretical Framework 

In examining and analyzing the effectiveness of using soap and water in hand washing as compared to using a hand sanitizer, it is essential to explore the existing theoretical frameworks. While various studies and interventions focusing on hand hygiene and cleanliness have always placed more emphasis on different needs of healthcare providers such as nurses and physicians, an approach based on theoretical framework would apply to diverse groups. These groups may include professional food handlers, home care providers and children in daycare centers among others. One of these theoretical frameworks involves the Bandura's social Cognitive theory in behavioral change as one of the approaches towards understanding some of the barriers to hand hygiene. This theory proposes that people the behavior of people such observation of hand hygiene is usually influenced by external factors rather than inner forces ( Glenn, 2013). 

The application of the social cognitive theory is essential in ensuring the provision of a comprehensive framework upon which the development of knowledge can be translated into effective intervention used in enhancing hand hygiene among different groups of people. According to Bennis (2015), behavioral change theory attempts to give an explorative and elaborate explanation associated with the reason for changing behavior among people in the society. This theoretical framework cites behavioral, personal and environmental feature as some of the major factors that often influence the conduct of people towards hand hygiene. A broader and more precise understanding of the social cognitive theory to the issue of hand hygiene may result in the establishment of effective initiatives and programs aimed at raising awareness of different methods of cleaning hands. The rationale for choosing the behavioral change as a theoretical framework in this research involves the consideration of various factors that influence the act of hand washing and the choice of the associated methods of facilitating more effectively. 

Review of Literature 

The findings by Luby et al . (2010) established that workers in various food industries often struggle with trying to get rid of various foreign materials from their hands with an increased level of efficiency and effectiveness. While the hand washing technique that uses soap and waters is more common, there has always been a desire for those concerned with the promotion of hand hygiene to look for more effective alternatives. In most case, the effectiveness in hand washing may be difficult to achieve considering that a vast majority of people do not always employ proper techniques and procedures. Some researchers have argued a hand sanitizer may be regarded as one of the most effective options of hand cleaning especially in situations characterized by scarcity or unavailability of water or soap. According to the views by Mathur (2011), health experts have recommended the present of a minimum of 60% content of alcohol in hand sanitizers used in hand washing to enhance its effectiveness in killing and eliminating most germs that may be present on the surface of the hand. However, it has been noted that one of the side effects commonly associated with hand sanitizers is that they could lead to drying of skin if too much of their quantity is used. For hands that are visibly dirty and soiled with different foreign materials such as oil and grease, cleaning with water and soap is sufficient and effective. 

Arguably, a hand sanitizer may apply only to the extent of making hands appear clean, especially if the presence of alcohol in it content is below sixty percent, rather than killing disease-causing germs. Previous studies focusing on establishing more effective ways of observing hand hygiene have demonstrated that plain soaps have an effect that is similar to that of antibacterial soaps when considering the prevention of bacteria-related diseases. Use of antibacterial soap sometimes may lead to increased bacterial resistance. The analysis by Darmayani, Askrening, and Ariyani (2017) reveals that proper development of the immune system in children may be inhibited by persistent use of hand sanitizers and antibacterial soaps. When one has several options of hand washing, it should always be remembered that that hand sanitizers ought not to be regarded as alternatives meant to replace the water and soap technic. Instead, they should be considered as a mechanism of observing hand hygiene owing to their effectiveness especially in the absence of soap and water. Almost every patient or healthcare worker is always faced with the risk of contracting an infection at a social place or within a healthcare facility while undergoing treatment or providing healthcare services. As such, one of the most effective ways of ensuring that both the patients and healthcare workers are protected from infections is observing hand hygiene appropriately. 

Methodology 

This research will adopt a combination of qualitative and quantitative methods. The design of the study used will involve a combination of grounded theory and phenomenology as specific approaches to the qualitative methodology. The rationale for the selected design consists of the consideration of means and techniques of acquiring credible and reliable data and information from a wide variety of sources including both primary and secondary sources. The grounded theory approach will utilize the theoretical framework to discover the existing social problems concerning the observation of hand hygiene as well as the manner in which a most effective means of its facilitation can be determined ( Garg, 2016). Further, the research will involve the formulation and development of propositions supported by the theoretical framework in evaluating different facts and arguments explaining the most effective and preferable means of conducting hand hygiene. 

Regarding phenomenology, the research will focus on examining and describing the unique experiences of individuals concerning hand washing under different conditions and circumstances. In this regard, the researcher will try to obtain the experience or feeling of people before describing the phenomenon of their experience. In the quantitative technique, the research will place more emphasis on collecting primary data and information from samples selected randomly where participants will be presented with questionnaires to obtain their views regarding a more effective means of hand washing. The sample size will involve a minimum of ten and a maximum of twenty participants from different healthcare facilities. Critical case and criterion methods of sampling will be adopted for this research. The exclusion and inclusion criteria for participation in the study will involve the consideration of various factors namely occupational, environmental and social. Before the distribution of the questionnaires to the participants, consent forms would be supplied to the prospective participants to enlighten concerning the details of the research and to obtain the consent ( Moralejo, 2013). 

Data Analysis 

The data analysis methods for the qualitative approach that will be adopted in research will include grounded theory, discourse analysis, and framework analysis. The discourse analysis will focus on examining data and information from secondary sources. The framework analysis will be more concerned with the identification of a thematic framework upon which data and information will be analyzed and evaluated. The application of grounded theory in data analysis will involve a predefined concept which is the effectiveness of different alternatives in hand washing. The analysis of quantitative data obtained in this research will include organization, summarizing and performance of exploratory analysis. Methods for displaying findings to be used will include graphical displays, tabulations and summary statistics ( Garg, 2016) . 

Applicability to Nursing 

The research on the determination of a more effective option when washing hands using soap and water in comparison to using a hand sanitizer is significant to the nursing. Most germs that are usually associated with the spread of severe infections from one individual to another are generally contained in hands and other parts of the body. In this regard, the problem is significant to nursing in the sense that it touches on a critical element that is extensively involved in the spread of diseases and illnesses from one person to another. Blumstein (2014) observes that hand hygiene is a critical means of ensuring that the spread of infections is prevented. Moreover, healthcare providers would be more concerned with the determination of a more effective means of hand washing and hygiene owing to the nature of their profession which involves handling different patients with various infections and medical conditions. Appropriate observation of hand hygiene is vital in nursing since it ensures that both the healthcare workers and patients are safe from contracting diseases. 

In contributing to the nursing knowledge, the research would assist in the identification of one of the effective ways of controlling the spread of infections among people in a healthcare facility or different social places. Besides, healthcare workers will benefit from the findings of this research by understanding the key areas of focus when trying to prevent the spread of infections amongst different populations and the areas of focus when creating public awareness about body hand and body hygiene. Many areas of nursing would considerably benefit from this study. These include the infections and disease prevention units, the area of cleaning and sanitation as well as the area. Enhancement of the standards and quality of nursing and healthcare provisions will also benefit significantly from the findings of this study (Luby et al ., 2010). 

References 

Bennis, W. (2015). Theory and method in applying behavioral science to planned organizational change. The Journal Of Applied Behavioral Science , 1 (4), 337-360. doi:10.1177/002188636500100404 

Blumstein, S. (2014). Improving hand-hygiene compliance and reducing healthcare -associated infections with automated hand-hygiene compliance monitoring. American Journal Of Infection Control , 42 (6), S117-S118. Doi 10.1016/j.ajic.2014.03.257 

Darmayani, S., Askrening, A., & Ariyani, A. (2017). Comparison of the number of bacteria between washing hands using soap and hand sanitizer as a bacteriology learning resource for students. Jurnal Pendidikan Biologi Indonesia , 3 (3), 258. doi: 10.22219/jpbi.v3i3.4862 

Garg, R. (2016). Methodology for research I. Indian Journal of Anaesthesia , 60 (9), 640–645. http://doi.org/10.4103/0019-5049.190619 

Glenn, C. (2013). Cognitive Free will Learning Theory. Procedia - Social And Behavioral Sciences , 97 , 292-298. doi: 10.1016/j.sbspro.2013.10.236 

Luby, S., Kadir, M., Yushuf Sharker, M., Yeasmin, F., Unicomb, L., & Sirajul Islam, M. (2010). A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh. Tropical Medicine & International Health , 15 (12), 1508-1516. doi: 10.1111/j.1365-3156.2010.02648.x 

Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. The Indian Journal Of Medical Research , 134 (5), 611–620. http://doi.org/10.4103/0971-5916.90985 

Moralejo, D. (2013). Handrubbing with an alcohol-based solution reduced healthcare workers' hand contamination more than handwashing with antiseptic soap. Evidence Based Nursing , 6 (2), 54-54. doi: 10.1136/ebn.6.2.54 

Appendices 

Appendix I: Questionnaire 

Details: 

Name: ……………………………………………………………………Date…………………………………… 

Facility…………………………………………………Service……………………………….City……………. 

Country……………………………………………………Age (Yrs)…………………………………………… 

Gender:   Female  Male 

Profession:   Nurse  Auxiliary nurse  Midwife  Medical doctor  Resident 

 Technician  Therapist  Nurse student  Medical student  Other 

Questions: 

I. Did you receive formal training in hand hygiene in the last three years? 

 Yes  No 

II. Do you routinely use a hand sanitizer for hand hygiene?  Yes  No 

III. Do you regularly use soap and water for hand hygiene?  Yes  No 

IV. Which one do you consider more effective in hand washing between hand sanitizer and soap and water?  Yes  No 

Appendix II: Consent Form 

Consent Form for Research Participation 

Title of Study 

Determination of effectiveness of hand washing soap and water compared to hand sanitizer

Description of the research 

You are invited to be part of this research conducted with the objective of establishing a more effective means of observing hand hygiene by comparing hand sanitizer and soap and water.

Description of participation 

Your participation will involve answering several questions based on your experiences and personal views regarding observing hand hygiene

Risks and discomforts 

To the best of the researcher's knowledge, there are no known risks associated with this research. However, the discomfort that is related to this research is the sharing of some personal details which will be addressed by ensuring that such details remain confidential and all information provided is used for studies only.

Potential benefits 

The research will assist in the identification of one of the effective ways of controlling the spread of infections among people in a healthcare facility or different social places. Also, healthcare workers will benefit from the findings of this research by understanding the key areas of focus when trying to prevent the spread of infections amongst different populations and the areas of focus when creating public awareness about body hand and body hygiene.

Protection of confidentiality 

High levels of confidentiality will be observed, and all information provided is used for studies only

Voluntary participation 

Your participation in this research study is voluntary

Consent 

I have read and understood this consent form. I hereby give my consent to participate in this study.

Participant’s signature_______________________________ Date________________