Date of Award

Summer 2021

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP) in Family Nurse Practitioner



Faculty Chair

Dr. Lori McGrath


Hand hygiene is one of the most significant measures for protecting nursing home residents from healthcare-associated infections (HAIs). An estimated 1.6 million to 3.8 million infections occur each year; of these infections, 32% of all healthcare-associated infections (HAIs) are urinary tract infections (UTI), 15% are pneumonia (lung infection), and 14% are bloodstream infections. The high incidence of HAIs in nursing homes is due to multiple factors such as understaffing, inadequately trained staff, staff to resident ratio, lack of antibiotics stewardship, and the increasing clinical complexity of the average nursing home. In addition, most long- term care (LTC) residents are older adults with multiple comorbidities, chronic medical conditions, and compromised immune systems. Despite these increased risks for HAIs among residents, health care workers (HCWs) in the LTC facility have not fully embraced guidelines on hand hygiene (HH); hence there is a clear gap between the recommended guidelines and what is practiced by HCWs in the LTC facility. This quality improvement project focused on the value of re-educating registered nurses and nursing assistants on HH practices as an approach to reduce the incidence of HAIs. Therefore, this capstone project aims to assess the gap between HH recommendations and practices in the LTC facility and examine individual and organizational factors that would foster improved hand hygiene.

Keywords: infection prevention, hand hygiene compliance, LTC facility, safety culture, HAIs, nursing knowledge belief, perception

Included in

Nursing Commons


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