Discussion module 3 Among outpatient nurses is hand hygiene education more effective in reducing hospital-acquired infections than the current practice of using alcohol hand sanitizer before and after every patient contact.The search terms used were hand hygiene hospital-acquired infection, healthcare hygiene and alcohol sanitizer, health care hygiene education and hand hygiene sanitizer. The search was in the following databases CINAHL Complete, Nursing Reference Center Plus and MEDLINE via PubMed.The original search returned thousands of articles and going by the titles,many were not relevant to the topic of interest. As I changed the search terms by adding Boolean operators, the article returned became more relevant and reduced in number.The rigor and effectiveness of a database search can be increased by using the following strategiesAdding filters to the search words, for example the search words hand hygiene education returned too many articles but when I added hospital acquired infections as a filter so that the full search word became ‘hand hygiene hospital acquired infections’. The number of articles returned reduced dramatically and became more relevant to the topic of interest.Eliminating words that do not add value to the search words and instead usingcontent specific words. The strategy of using