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Hand Hygiene Essay

Hand hygiene is a major health issue within hospitals, school systems and within the general public across the United States. Hand washing is one of the most important healthy actions a person can do. Proper hand hygiene aids in the prevention and spread of infections such as respiratory infections or gastrointestinal diseases caused by enteric pathogens. These along with other infectious diseases are commonly caused by poor hand hygiene practices along with the decreased frequency of hand washing. These infections can typically be found in preschool children between the ages of three to five where proper hygiene techniques such as sneezing into the inside of your arm have not been taught properly1. Preschoolers generally spend the day in a day care center or preschool where they are under the supervision of a teacher.

The teacher is their role model and is the person whom their behaviors will mimic. There are over 2 million children under the age of five who die each year from diarrheal diseases or respiratory issues such as pneumonia2. One study showed that hand washing can reduce the risk of respiratory infections by 16%3. Researchers have also found that about 60 to 70% of absences from day care centers that take care of preschool aged children are due to respiratory infections4. These issues can be properly addressed by teaching good hand hygiene techniques to children age’s three to five so that they can prevent the spread of infections and promote healthy lives.

Theory Briefly describe the theory you will use and the rationale for using this theory (cite other research or similar programs that have used the theory)

The social cognitive theory (SCT) is the basis of the Hand washing Ugly Germs (H.U.G.) program and why it was created. . The social cognitive theory states that a behavior is part of an uninterrupted cycle, which includes the individual, their peers and their social environment. This theory’s main fundamental is that an individual learns by observing others. The SCT also includes an individual’s interaction with an environment as well as having self-efficacy or the confidence that an individual has that about a task5.

The purpose of using this theory is because each portion of the theory can support what the outcomes of the program should be. It also incorporates learning through observation of others and their behaviors. People tend to learn and adapt their behaviors from other people they may see as role models6. Another purpose for using the SCT is because it includes the role of the environment and how it affects an individual’s behaviors or decisions7. The SCT is an essential part behind the H.U.G. program.

Program Proposed program approach and description of specific program components. How will you incorporate the theory into the actual program or services? The majority of your paper should focus on the Program and the application of theory to developing the program.

The H.U.G. program is intended for preschool children and their teachers with the overall goal of being to reduce the spread of infections within each site. The program is designed to be implemented within the schools or day care centers in the State of Connecticut. H.U.G. intends to teach proper hand hygiene techniques to preschool children under the direction of a teacher or supervisor as means to reduce the spread of infections within these educational sites. The hygiene intervention focuses on hand hygiene, the environment in which it takes place and the individuals peers and role models. The preschool educators or day care center conductors will provide education materials to the children in a fun yet educational way such as by posters, videos and interactive lessons.

The education materials will explain how germs are passed through touching, hugging, sneezing, coughing and when an individual does not wash their hands properly it can make others ill. The educators will be provided with either traditional liquid or anti-bacterial soap to use for hand washing. Educators and staff are encouraged to wash their hands in order to set examples for the preschool children. These role models will do demonstrations of proper hand hygiene with each individual child to ensure good techniques. It is recommended to teach the child that they should first turn on the water and wet their hands. They will then pump one or two “squirts” or “globs” of soap into their hands and rub the front and back of their hands.

The child should count for about 15 seconds and it is suggested that they say the alphabet or sing happy birthday aloud to make it easier. After completing the 15 seconds the child should rinse their hands and take a paper towel to dry them off as well as shut the water off. It is important that the children know to wash their hands when arriving at the site, before eating, after toileting, after they have wiped their nose and before leaving the site for the day. It is also important for the children to be aware of how to cover their cough or sneeze by blowing into their arm and not onto their hands or into the air. All of these education materials can be provided to each child and can be implemented in their everyday lives not only in the classroom but at home as well.

Program and Theory

The H.U.G. program was created based on the SCT. Self-efficacy is one of the main principles of the SCT. The program helps to encourage children to wash their hands but also feel confident that they can do it on their own and by doing so they are building self-efficacy. The H.U.G. program also mirrors the idea of observing others which is why it was implemented into preschools and day care centers. These educational places are led by teachers and staff, which the children see as role models. Therefore, because the preschool children typically mimic the staff’s actions, it is important for staff to set an example of proper hand hygiene.

The intention of this is so that the children will learn when and how to wash their hands to prevent the spread of germs. The environment also plays a key part in why this program uses the SCT. The program will be implemented in preschools and day care centers because of the environment, which consists of the children’s role models and peers. Also due to the fact that this environment allows the children to be closely confined to an area with their peers, it allows them to make a positive difference in each other’s hygiene habits. By doing this, it should reduce the spread of respiratory and gastrointestinal infections as well as keep each individual healthy so they are able to stay in school.

Evaluation General outline of how you will evaluate your program, including any limitations that you might encounter

The H.U.G. program will be evaluated over a nine-month period while the preschool is in session. The program will be over seen by the Connecticut Department of Public Health. Each place will be observed and evaluated at the beginning, middle and end of the school year. They will be evaluated on how many children contracted a respiratory or gastrointestinal illness during that nine-month period, how many children were absent during this time period and the overall hand hygiene process led by the educator and followed by each child. Every site will be given positive thoughts over the time period as well as ways to improve if necessary.

There are a few limitations to the H.U.G. program. One limitation is that it is very time consuming for the state Department of Public Health to make it out to all sites within a nine-month period. Another limitation is that each child is not evaluated outside of school. The child would be practicing proper hygiene at school but unfortunately there is no way to check outside of the school environment. However, they will be instructed to wash their hands when they arrive at the site and before they leave for the day. These limitations could possibly change the results slightly but should not affect them drastically.

Summary Provide a brief summary of why your proposed program and its theoretical base will be effective at addressing the health issue

The H.U.G. program was created in order to address the spread of infection and hand hygiene issue within preschools and day care centers. These are places where preschoolers will learn good behaviors from their role models. The staff teaches each individual why hand washing is important and how to properly wash away the germs. The overall goal is for each student to be able to demonstrate how to properly wash his or her hands and to prevent the spread of infection at each site.


1. Obeng C. Personal Cleanliness Activities in Preschool Classrooms. Early Childhood Education Journal [serial online]. August 2008;36(1):93-99. Available from: Academic Search Premier, Ipswich, MA. Accessed October 30, 2014.

2. “Handwashing: Clean Hands Save Lives.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec. 2013. Web. 25 Oct. 2014.

3. Rabie, T., and V. Curtis. “Result Filters.” National Center for Biotechnology Information. U.S. National Library of Medicine, 11 Mar. 2006. Web. 25 Oct. 2014.

4. Hedin K, Petersson C, Cars H, Beckman A, Håkansson A. Infection prevention at day-care centres: Feasibility and possible effects of intervention. Scandinavian Journal Of Primary Health Care [serial online]. March 2006;24(1):44-49. Available from: Academic Search Premier, Ipswich, MA. Accessed October 29, 2014.

5. Behavioral Theory in Public Health. Burlington: Jones and Bartlett Learning, 2015. Print.

6. Spencer, Maureen. “Creative Hand Hygiene Programs to Motivate Staff.” New England Baptist Hospital. Lecture.

7. Gudnason T, Hrafnkelsson B, Laxdal B, Kristinsson K. Does hygiene intervention at day care centres reduce infectious illnesses in children? An intervention cohort study. Scandinavian Journal Of Infectious Diseases [serial online]. May 2013;45(5):397-403. Available from: Academic Search Premier, Ipswich, MA. Accessed October 29, 2014.

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