Abstract

Introduction and Background

Healthcare-associated infections (HAIs) threaten patient safety, affecting about 1 in 25 hospitalized patients. Clostridium difficile infection (CDI) is a significant contributor, impacting both high-risk groups and the general population. Proper hand hygiene is crucial for preventing CDI transmission. In the U.S., hospital-acquired CDI costs over $1.5 billion annually and causes nearly 500,000 cases and I15,000 deaths each year. California reported 3,526 CDI cases in acute care hospitals, with Loma Linda University hospitals accounting for 16 cases, or 23% of their health system's infection rate.

Methodology

Nurses in the 6A West-Transplant Unit received a PowerPoint presentation on when and how to educate patients on hand hygiene and proper handwashing to prevent infection. Several tools were used for this DNP project. They included the Nursing Demographics Survey, the WHO Perception Survey for Healthcare Workers, the Lesson Plan and Nursing PPT education, the CDC post-course evaluation, the Patient Demographics Survey, the Patient Handwashing Poster and Microlearning Video, and the Patient Chart Audit Data Collection Tool.

Result

The proportion of nursing staff who considered themselves very knowledgeable increased significantly after the educational intervention utilizing the WHO-recommended handwashing poster, and a significant increase in perceived comfort, confidence, and safety was noted post-survey. Most nurses considered the educational activities they engaged in to be essential; however, many clinical staff reported that maintaining proper hand hygiene demands considerable effort in the CDC post-intervention survey. In assessing patient adherence to the teaching, the initial training was highly effective in encouraging adherence; however, handwashing adherence declined after the fifth week, suggesting that reinforcement and support may be needed to maintain adherence to hand hygiene practices over time. Finally, the C. diff rate at the end of the six-week intervention decreased to 1 infection, indicating the intervention's efficacy.

Conclusion

Improved patient hand hygiene adherence as recorded by bedside nurses. Patients reported on the demographics survey that they received education and had the opportunity to wash their hands with the bedside RN. This led to reduced C. Diff rates, as patients participated and became aware of how to prevent the transmission of infection and break the chain of infection.

Keywords: included UTI, Transplant, Global burden of C diff., hand hygiene, hand washing, infectious disease, patient empowerment, Microlearning Video, just-in-time education, nursing perception, immunocompromised patient, c. diff, prevention, and nonpharmacological interventions for the prevention of infection. I broadened my search to include patient compliance, empowerment, and hand hygiene education.

LLU Discipline

Nursing

School

School of Nursing

First Advisor

Robin Dudley Pueschel

Second Advisor

Salem Dehom

Degree Name

Doctor of Nursing Practice (DNP)

Year Degree Awarded

2026

Date (Title Page)

Spring 2026

Language

English

Type

Doctoral Project

Page Count

94 p., 1 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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