1 2 Introduction Infections acquired in a hospital or acute care setting related to the patient's original ailment are known as nosocomial infections. Because of the link between healthcare quality and nosocomial infection, infection control measures are now widely applied in every healthcare facility (Collins, 2008). Since these facilities are responsible for guaranteeing people's health and well-being, it is critical to successfully prevent the spread of infection that can be acquired in a hospital setting. Hand hygiene is intended to reduce the risk of hospital-acquired infections (Monegro et al., 2020). The hand hygiene of patients is just as vital as the hand hygiene of healthcare staff. Hand washing should be done correctly to remove dangerous microorganisms from the skin. Hand washing is the single most important and effective strategy to prevent and manage cross-infection among healthcare workers. The purpose of this study is to identify the most effective way of preventing nosocomial infection among Med surge adults over 65 years. Project Question For adults over 65 years, does the use of handwashing by nurses on the med surge floor reduce the future risk of nosocomial infection compared to hand sanitizer? Title of the Project The title of the project is preventing nosocomial infection. Project Beneficiaries This project will benefit the health care workers since they will know and understand the effective way of preventing nosocomial infections. Patients will benefit since the risk of contracting nosocomial infections will reduce. 3 Location of the target group This review will be conducted elect any hospital in Las Vegas, Nevada, since the med surge floor adults over 65 years are located there. Project period The project will take 12 weeks and thus will commence on 1st September to 31st October. The project will take a period of three months that equals 12 weeks. Therefore, the first and thirdmonth control measures will be implemented using the standard hand washing techniques. In the second month, the handwashing sanitizer was used to compare the infection rates using the handwashing technique and hand sanitizer. Budget requirements for the project In this study, the main requirements are the handwashing products and hand sanitizers, and of which most hospitals are well equipped. Therefore, significant expenses will be on printing the questionnaire to be filled by the staff so as to determine whether they are satisfied with the product. That is a minor expense, and hence can be settled using savings. Reasons for this project The reason for working on this project is because one prevention method of Covid-19 is hand washing. Therefore, understanding which method is more efficient in preventing infections is crucial. What to achieve in this project 4 This project aims to find the most efficient way of preventing nosocomial infections. As a result, the main aim is to achieve a risk reduction of nosocomial infections. Project implementation To effectively conduct this study, a combination of qualitative and quantitative methods will be used. Our research question is that a research study will be shown in the hospital ICU for this review. Thirty nurses posted in the ICU will be involved in the study. Data collection will be done over the three months of the test. Also, health practitioners will be required to fill out some questionnaires so as to determine their level of satisfaction in using either of the test products. Project long term effect The project's long-term effect is that geriatric patients will have a minimized risk of contracting nosocomial infection. Sustainability of the project Due to the global COVID-19 pandemic, the sustainability of the project is uncertain since most hospitals have impended restrictions on access to some hospital departments. Also, most patients have ventured to home-based healthcare, where the majority receive medical services from home due to the pandemic. Project Risks Among the risks identified are barriers to access some hospital departments and the dangers of contracting COVID-19 since the healthcare practitioners also attend to COVID-19 patients, which is an airborne disease. The aim is to strictly follow and apply the COVID-19 5 measures to minimize the risk. In case of barriers to access in a particular hospital department, we will utilize another accessible department. Project barriers The primary barrier is a denial of access in the hospital. The team will have to research the various hospitals available in Las Vegas and then make several requests. 6 Literature review In the prevention of nosocomial infections, several measures can be put into place. The primary measure identified to minimize the infections is hand washing (Pittet & Allegranzi, 2019). Medical practitioners are expected to frequently wash their hands after attending to one patient since most encounter body fluids that carry infections. In this study, I will look at handwashing to prevent nosocomial infections compared to hand sanitizers. According to Haque et al. (2020), the concept and importance of handwashing inpatient care were first theorized in the early 19th century. He identifies proper hand hygiene to be the least expensive method of minimizing the spread of infections. Farmani et al. (2019) added that patients in the Intensive care Unit (ICU) are at a greater risk of having a nosocomial infection. He argues that health practitioners are the common channel of transmitting the infections and thus recommend the primary step to preventing the infections. In support of the importance of handwashing Haque (2020) describe nosocomial infections as an indication of poor compliance with handwashing hygiene. Unfortunately, most health practitioners are non-compliant with handwashing procedures, thus increasing the rate of nosocomial infections (Haque et al., 2020). Healthcare personnel should set examples for their patients by exercising regular hand washing to help reduce the spread of nosocomial infections. According to Kampiatu and Cozean (2015), hand washing is recommended by the United States Centers for Disease Control (CDC), which should take 1-2 minutes. However, they argue that most health practitioners take less than 15 seconds, even with the available alcohol-based sanitizers. Kampiatu and Cozean (2015) argue that traditional alcohol-based sanitizers do not provide continuous protection against infections. According to them, hand sanitizers evaporate 7 and thus end the antimicrobial activity; hands can easily be contaminated once exposed to an infected surface, leaving patients unprotected. For this reason, hand washing is more effective compared to hand sanitizers. According to Haque et al. (2020), hand hygiene (HH) should be embraced as an automatic behavior by patients and health care professionals. In most instances, the authors proposed that the HealthCare workers risk distributing pathogenic microorganisms to patients through their hands. To prevent this spread, effective handwashing with soap and water was concluded as the best approach. Conclusion Nosocomial infections are amongst the common issues affecting healthcare setups. However, by implementing effective hand washing techniques by both patients and hath care professionals, the spread of the infections could be contained. Although hand sanitizers may be necessary for eliminating pathological microorganisms, they are not as effective as handwashing. Sanitizers evaporate at a higher rate creating more room for pathogens exposure. Therefore, sanitizers should be used only for a limited time. Embracing proper handwashing procedures will help in preventing the spread of infections at all costs. 8 References Collins, A. S. (2008). Preventing Health Care–Associated Infections. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. https://www.ncbi.nlm.nih.gov/books/NBK2683/. Farmani, Z., Kargar, M., Khademian, Z., Paydar, S., & Zare, N. (2019). The effect of training and awareness of subtle control on the frequency of hand hygiene among intensive care unit nurses. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4635-z Haque,M.,MCkimm,J.,Sartelli,M.,Dhingra,S.,Labricciosa,F.M.,Islam,S.,Jahan,D…………&Char an.,J.(2020). Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. DovePress, 2020 (13), 1765-1780. https://doi.org/10.2147/RMHP.S269315 Kampiatu, P., & Cozean, J. (2015). A Controlled, Crossover Study of a Persistent Antiseptic to Reduce Hospital-Acquired Infection. African Journal of Infectious Diseases, 9(1), 6–9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325352/ Monegro, A. F., Muppidi , V., & Regun, H. (2020). Hospital Acquired Infections. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK441857/.