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Question: Design a Capstone Project Proposal on Significance of Hand Hygiene related to Nosocomial Infections. Answer: Clinical issue: The current issue faced in health care clinic is the rise in nosocomial or health-care associated infection. About hundreds of millions of people are affected by nosocomial infection worldwide leading to mortality and increase in financial burden of the health care system. The environment of the hospital facilitates transmission of several harmful pathogens like Clostridum difficile, methicillin resistant Staphylococcus aureus and other pathogens (Anderson et al., 2014). Apart from environmental reservoirs of infection in health care setting, lack of hand hygiene practices among nurses and other staff is the major cause of nosocomial infection (Martnez-Resndez et al., 2014). Although hand hygiene has been recognized as one of the major elements of infection control activities to minimize nosocomial infection, very few nurses are found to comply with hand hygiene procedures. The most common reason for non-compliance to hand hygiene practice includes increased workload, lack of awarene ss about the importance of infection control, poor perception about hygiene, more priority for other clinical responsibility and lack of time. Apart from this, lack of institutional written guideline on hand hygiene and ignorance on the transmission of infection lead to non-adherence to hand hygiene guideline (Teker et al., 2015). Significance of the problem: Considering the rise in morbidity and mortality due to non-adherence to hand hygiene and rise in nosocomial infection, addressing this issue in clinical practice is critical. Focusing on increasing adherence and awareness about hand hygiene in nurse is important because of its ability to restrict transmission of harmful pathogen. Nurses are the main carrier of infection as they work in crowded area and are exposed to diverse patient with illness. Secondly, they often handle blood sample and syringes contaminated with pathogens (Huis et al., 2013). Hence, hand hygiene is extremely important for nurse before coming in contact with patient. Huang et al., (2014) has proved that complying to hand hygiene practice is effective in reducing the rate of transmission of pathogens on hands and consequently reducing nosocomial infection. Suggestion or educational need: Multiple strategies are needed to reduce the ignorance of staff towards hand hygiene. Firstly, system level change and administrative support is needed so that clinical organization emphasizes on hand hygiene and establish written hand hygiene guideline (Le Thi Anh Thu et al., 2015). Another important requirement will be to give intensive training and education to nurses regarding the clinical priority of hand hygiene and its effectiveness in reducing the rate of infection. Educational interventions by visual aids regarding gross contamination of hands with pathogen on patient contact and impact of alcohol rub on decontamination might also encourage nurses to strictly engage in hand hygiene. Free availability of hand disinfectants along with training has the potential to increase hand hygiene compliance (Luangasanatip et al., 2015). Implications The implication of this intervention is huge as hand hygiene is the most simple protocol for controlling infection, yet it reduces infection and comorbidities both in patients as well as health care staffs. Therefore, if clinical leaders take hand hygiene as an organization priority and intervene to implement hand hygiene guidelines and disciplinary action, incidence of nosocomial infection is likely to reduce. Educational intervention will increase the motivation of nurse in making hand hygiene a regular practice in clinical setting (Chassin et al., 2015). Reference Anderson, D. J., Podgorny, K., Berros-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., ... Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update.Infection Control Hospital Epidemiology,35(06), 605-627. Chassin, M. R., Mayer, C., Nether, K. (2015). Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance.The Joint Commission Journal on Quality and Patient Safety,41(1), 4-12. Huang, G. K., Stewardson, A. J., Grayson, M. L. (2014). Back to basics: hand hygiene and isolation.Current opinion in infectious diseases,27(4), 379-389. Huis, A., Schoonhoven, L., Grol, R., Donders, R., Hulscher, M., van Achterberg, T. (2013). Impact of a team and leaders-directed strategy to improve nurses adherence to hand hygiene guidelines: a cluster randomised trial.International journal of nursing studies,50(4), 464-474. Le Thi Anh Thu, M. D., Van Trang, D. T., Wertheim, H. F., Son, N. T. (2015). Cost-effectiveness of a hand hygiene program on health careeassociated infections in intensive care patients at a tertiary care hospital in Vietnam.American Journal of Infection Control,30, e1-e7. Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth, S., ... Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis.bmj,351, h3728. Martnez-Resndez, M. F., Garza-Gonzlez, E., Mendoza-Olazaran, S., Herrera-Guerra, A., Rodrguez-Lpez, J. M., Prez-Rodriguez, E., ... Camacho-Ortiz, A. (2014). Impact of daily chlorhexidine baths and hand hygiene compliance on nosocomial infection rates in critically ill patients.American journal of infection control,42(7), 713-717. Teker, B., Ogutlu, A., Gozdas, H. T., Ruayercan, S., Hacialioglu, G., Karabay, O. (2015). Factors Affecting Hand Hygiene Adherence at a Private Hospital in Turkey.The Eurasian journal of medicine,47(3), 208.