Hand Hygiene Practice and Incidence of Healthcare-Associated Infections in Mbale Regional Referral Hospital, Rural Eastern Uganda

Background: Though high hand hygiene (HH) levels significantly reduce the risk of healthcare-associated infections (HCAIs), the current cost of HCAIs and the impact of optimal HH practices on HCAIs are poorly defined. The last NHS England financial assessment was in 2009. Methods: The number of HCAIs per bed per year for NHS England were calculated and average costs were attributed using data from three sources; National Audit Office report, a commercially available calculator, and a financial analysis by a specialist paediatric hospital in England. Improved HH compliance for NHS England was based on a sustained rise in compliance rates from 50 to 80% combined with an HCAI reduction of at least 20%. The cost savings based on such improvements were then calculated. Results: In 2020, it is estimated that the number of HCAIs per bed per year ranges from 3.0 to 9.3, with a midpoint of 5.1. The direct costs of HCAI to NHS England were found to lie between £1.6 and £5 billion. Based on a 20% reduction in HCAI rates, this could lead to cost savings of between £322 million and £1 billion per year. Conclusion: Current direct costs of HCAIs consume approximately 1.3% to 4.1% of NHS England’s annual budget. Improving HH compliance among healthcare workers can lead to significant cost savings. There appears to be a strong financial argument for investment into innovative HH compliance technologies that have been historically perceived as too expensive.

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Individual Monitoring Improves and Sustains Hand Hygiene (HH) Compliance and Correlates with a Reduction in Healthcare-Associated Infections (HAI) in Multicenter Study

American Journal of Infection Control ◽

10.1016/j.ajic.2017.04.269 ◽

2017 ◽

Vol 45 (6) ◽

pp. S27

Author(s):

Megan E. Read ◽

Jessica B. Buckner ◽

Liberty Dykehouse ◽

LeeAnn Phipps

Keyword(s):

Hand Hygiene ◽

Multicenter Study ◽

Healthcare Associated Infections ◽

Healthcare Associated

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Comorbidities and Factors Associated with Mortality among Children under Five Years Admitted with Severe Acute Malnutrition in the Nutritional Unit of Jinja Regional Referral Hospital, Eastern Uganda

International Journal of Pediatrics ◽

10.1155/2020/7809412 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Desire Banga ◽

Melvis Baren ◽

Namale Vivian Ssonko ◽

Franck Katembo Sikakulya ◽

Yves Tibamwenda ◽

...

Keyword(s):

Severe Acute Malnutrition ◽

Referral Hospital ◽

Acute Malnutrition ◽

Health Concern ◽

Regional Referral Hospital ◽

Children Under Five ◽

Under Five ◽

Factors Associated ◽

Eastern Uganda ◽

Children Under 5

Background. Mortality among children with severe acute malnutrition remains an immense health concern in the hospitals in developing countries, but its attributes are not completely assessed in various hospital settings. The aim of this study was to determine the proportion of mortality, the comorbidities, and factors associated with in-hospital mortality among children under five years of age admitted with severe acute malnutrition at Jinja Regional Referral Hospital, Eastern Uganda. Methods. This was a hospital-based analytical and descriptive prospective cohort study conducted in the nutritional unit of Jinja Regional Referral Hospital. A total of 338 children and their caretakers who met the criteria were consecutively enrolled into the study. Descriptive statistics were used to each of the independent factors, and comorbidities were subjected to chi-squared test followed by logistic regression analysis to assess its association incidence of mortality among children. All independent variables with p values ≤ 0.05 were entered into a multivariate model for factors and comorbidities independently. Factors and comorbidities with p values ≤ 0.05 were considered as associates of mortality among children. Results. Of the 338 children under 5 years of age enrolled, 49 (14.5%) died, although the majority of children were diagnosed with dehydration, 128 (37.9%); pneumonia, 127(37.6%); and malaria, 87(25.7%). Anemia ( aRR = 2.9 , 95% CI: 1.23-6.62, p = 0.01 ), bacteremia ( aRR = 10.0 , 95% CI: 3.62-29.01, p = 0.01 ), HIV ( aRR = 4.8 , 95% CI: 1.42-16.30, p < 0.01 ), TB ( aRR = 4.3 , 95% CI: 1.28-14.49, p < 0.02 ), and shock ( aRR = 60.9 , 95% CI: 9.05-410.28, p < 0.01 ) were the comorbidities significantly associated with a likelihood of mortality. Conclusions. The mortality among children under 5 years of age admitted with severe acute malnutrition is still high (14.5% versus 5%). The comorbidities are significantly associated with mortality. The clinicians are recommended to follow-up closely patients with severe acute malnutrition and to focus on the critical comorbidities identified.

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Cost-Effectiveness of Exploratory Laparotomy in a Regional Referral Hospital in Eastern Uganda

Journal of Surgical Research ◽

10.1016/j.jss.2019.07.037 ◽

2020 ◽

Vol 245 ◽

pp. 587-592 ◽

Cited By ~ 1

Author(s):

Nikhil Bellamkonda ◽

Girish Motwani ◽

Andrew Hyginus Wange ◽

Christopher De Boer ◽

Fred Kirya ◽

...

Keyword(s):

Cost Effectiveness ◽

Exploratory Laparotomy ◽

Referral Hospital ◽

Regional Referral Hospital ◽

Eastern Uganda

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1314. From Book to Bedside: Theoretical and Applied Knowledge on the Topic of Healthcare-Associated Infections in Second-Year Nursing Students from a Croatian University

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1147 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S402-S402

Author(s):

Tomislav Mestrovic ◽

Goran Kozina ◽

Marijana Neuberg ◽

Rosana Ribic

Keyword(s):

Nursing Students ◽

Hand Hygiene ◽

Health Workers ◽

Healthcare Associated Infections ◽

Standard Precautions ◽

Significant Difference ◽

Level Of Knowledge ◽

Second Year ◽

Healthcare Associated ◽

Applied Knowledge

Abstract Background Adequate training of health workers is pivotal in the prevention of healthcare-associated infections (HAI). Our aim was to assess the theoretical and applied knowledge about the risk factors and effective measures of HAI prevention (most notably the use of standard precautions and hand hygiene practices) in second year undergraduate university nursing students that have already completed obligatory courses in microbiology, infectious diseases and epidemiology. Methods This study included a whole generation of second year undergraduate nursing students, comprised of 161 female and 25 male participants (186 in total), from a public university in Croatia (University Centre Varaždin, University North). They were given an anonymous questionnaire (developed on the model used by Tavolacci et al. in 2008) covering three domains: General Knowledge of HAI, Standard Precautions (SP) and Hand Hygiene (HH). The acceptable score overall (max. 30) and for each area (max. 10) was arbitrarily set at ≥ 20 and ≥ 7, respectively (in accordance with prior research). Results The age range of surveyed students was 19–37 (mean: 21.97, median: 21, mod: 20). An accurate definition of nosocomial infections was provided by 98.92% students (with 60.75% of them defining it as the infection occurring 48 hours after hospital admission). The overall score was 21.5, which indicates sufficient level of applied knowledge of healthcare-associated infections. Very high level of knowledge was observed for the SP area (total score of 9.5); however, the level of knowledge in HAI and HH domains was inadequate (5.9 and 6.1, respectively). There was no statistically significant difference in the overall or specific scores between male and female students (P > 0.05). Formal teaching during the curriculum was students’ primary source of information (60.22%), followed by practical learning in the ward during work (23.65%), formal teaching in the ward (9.68%) and self-learning (6.45%). Conclusion Periodical checking of nursing students’ knowledge on HAI and corresponding curriculum modifications in obligatory courses tackling this topic are advised in order to fill the knowledge gaps, improve training, reduce infection rates and increase compliance with prevention measures. Disclosures All authors: No reported disclosures.

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Patients' Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

Infection Control and Hospital Epidemiology ◽

10.1086/675826 ◽

2014 ◽

Vol 35 (5) ◽

pp. 585-588 ◽

Cited By ~ 9

Author(s):

Anna Barker ◽

Ajay Sethi ◽

Emily Shulkin ◽

Rachell Caniza ◽

Sara Zerbel ◽

...

Keyword(s):

Hand Hygiene ◽

Intrinsic Value ◽

Healthcare Associated Infections ◽

Hospital Hygiene ◽

Factors Associated ◽

Hygiene Practices ◽

Hospital Patients ◽

Hospital Practices ◽

Healthcare Associated ◽

At Home

We examine factors associated with hand hygiene practices of hospital patients. Hygiene in the hospital decreased compared to that at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

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Changes in healthcare-associated infections after the introduction of a national hand hygiene initiative

Healthcare Infection ◽

10.1071/hi14033 ◽

2014 ◽

Vol 19 (4) ◽

pp. 128-134 ◽

Cited By ~ 5

Author(s):

Adrian G. Barnett ◽

Katie Page ◽

Megan Campbell ◽

David Brain ◽

Elizabeth Martin ◽

...

Keyword(s):

Hand Hygiene ◽

Healthcare Associated Infections ◽

Healthcare Associated

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Patients' Beliefs and Perceptions of Their Participation to Increase Healthcare Worker Compliance with Hand Hygiene

Infection Control and Hospital Epidemiology ◽

10.1086/599118 ◽

2009 ◽

Vol 30 (9) ◽

pp. 830-839 ◽

Cited By ~ 61

Author(s):

Yves Longtin ◽

Hugo Sax ◽

Benedetta Allegranzi ◽

Stéphane Hugonnet ◽

Didier Pittet

Keyword(s):

Hand Hygiene ◽

Healthcare Worker ◽

Patient Participation ◽

Healthcare Workers ◽

Patient Empowerment ◽

Healthcare Associated Infections ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Active Involvement ◽

Healthcare Associated

Background.Research suggests that patients could improve healthcare workers' compliance with hand hygiene recommendations by reminding them to cleanse their hands.Objective.To assess patients' perceptions of a patient-participation program to improve healthcare workers' compliance with hand hygiene.Design.Cross-sectional survey of patient knowledge and perceptions of healthcare-associated infections, hand hygiene, and patient participation, defined as the active involvement of patients in various aspects of their health care.Setting.Large Swiss teaching hospital.Results.Of 194 patients who participated, most responded that they would not feel comfortable asking a nurse (148 respondents [76%]) or a physician (150 [77%]) to perform hand hygiene, and 57 (29%) believed that this would help prevent healthcare-associated infections. In contrast, an explicit invitation from a healthcare worker to ask about hand hygiene doubled the intention to ask a nurse (from 34% to 83% of respondents; P < .001) and to ask a physician (from 30% to 78%; P < .001). In multivariate analysis, being nonreligious, having an expansive personality, being concerned about healthcare-associated infections, and believing that patient participation would prevent healthcare-associated infections were associated with the intention to ask a nurse or a physician to perform hand hygiene (P < .05). Being of Jewish, Eastern Orthodox, or Buddhist faith was associated also with increased intention to ask a nurse (P < .05), compared with being of Christian faith.Conclusions.This study identifies several sociodemographic characteristics associated with the intention to ask nurses and physicians about hand hygiene and underscores the importance of a direct invitation from healthcare workers to increase patient participation and foster patient empowerment. These findings could guide the development of future hand hygiene-promotion strategies.

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