An exploratory study of safety culture, biological risk management and hand hygiene of healthcare professionals

Background: In low- and middle-income country (LMIC) healthcare facilities, gaps in infection prevention and control (IPC) practices increase risk of healthcare-associated infections (HAIs) and mortality among hospitalized neonates. Method: In this quasi-experimental study, we implemented the Comprehensive Unit-based Safety Program (CUSP) to improve adherence to evidence-based IPC practices in neonatal intensive care units (NICUs) in 4 tertiary-care facilities in Pune, India. CUSP is a validated strategy to empower staff to improve unit-level patient safety. Baseline safety culture was measured using the Hospital Survey on Patient Safety Culture (HSOPS). Baseline IPC assessments using the Infection Control Assessment Tool (ICAT) were completed to describe existing IPC practices to identify focus areas, the first of which was hand hygiene (HH). Sites received training in CUSP methodology and formed multidisciplinary CUSP teams, which met monthly and were supported by monthly coaching calls. Staff safety assessments (SSAs) guided selection of multimodal interventions. HH compliance was measured by direct observation using trained external observers. The primary outcome was HH compliance, evaluated monthly during the implementation and maintenance phases. Secondary outcomes included CUSP meeting frequency and HH compliance by healthcare worker (HCW) role. Result: In March 2018, 144 HCWs and administrators participated in CUSP training. Site meetings occurred monthly. During the implementation phase (June 2018–January 2019), HH monitoring commenced, sites formed their teams, completed the SSA, and selected interventions to improve HH based on the WHO’s IPC multimodal improvement strategy: (1) system change; (2) training and education; (3) monitoring and feedback; (4) reminders and communication; and (5) a culture of safety (Fig. 1). During the maintenance phase (February–September 2019), HH was monitored monthly and sites adapted interventions as needed. HH compliance improved from 58% to 70% at participant sites from implementation to maintenance phases (Fig. 2), with an odds ratio (OR) of 1.66 (95% CI, 1.50–1.84; P < .001). HH compliance improved across all HCW roles: (1) physician compliance improved from 55% to 67% (OR, 1.69; 95% CI, 1.42–2.01; P < .001); (2) nurse compliance from 61% to 73% (OR, 1.68; 95% CI, 1.46–1.93; P < .001); and (3) other HCW compliance from 52% to 62% (OR, 1.48; 95% CI, 1.10–1.99; P = .010). Conclusion: CUSP was successfully adapted by 4 diverse tertiary-care NICUs in Pune, India, and it resulted in increased HH compliance at all sites. This multimodal strategy is a promising framework for LMIC healthcare facilities to sustainably address IPC gaps and reduce HAI and mortality in neonates.Funding: NoneDisclosures: Aaron Milstone, Johns Hopkins University, BD (consulting)

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Features of educational interventions that lead to compliance with hand hygiene in healthcare professionals within a hospital care setting. A BEME systematic review: BEME Guide No. 22

Medical Teacher ◽

10.3109/0142159x.2012.680936 ◽

2012 ◽

Vol 34 (6) ◽

pp. e406-e420 ◽

Cited By ~ 22

Author(s):

Mary Gemma Cherry ◽

Jeremy M. Brown ◽

George S. Bethell ◽

Tim Neal ◽

Nigel J. Shaw

Keyword(s):

Systematic Review ◽

Hand Hygiene ◽

Hospital Care ◽

Care Setting ◽

Healthcare Professionals ◽

Educational Interventions

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Correlation between Antibiotic Consumption and Hand Hygiene Compliance Among Anesthesia and Intensive Care Healthcare Professionals

The Open Anesthesia Journal ◽

10.2174/2589645802014010042 ◽

2020 ◽

Vol 14 (1) ◽

pp. 42-48

Author(s):

Emanuela Santoro ◽

Marco Fiore ◽

Sebastiano Leone ◽

Armando Masucci ◽

Roberta Manente ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Healthcare Professionals ◽

Tertiary Care ◽

Antibiotic Consumption ◽

Alcoholic Solution ◽

Hand Washing ◽

Hospital Acquired Infections ◽

Consumption Data ◽

Hospital Acquired

Aims: The aim of this study was to investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals working in the Department of Anesthesia and Intensive Care of a tertiary care University Hospital. Background: Two centuries have passed since the discovery of Semmelweis that the “puerperal fever” was due to an infection transmitted by the hands. Currently the hand hygiene is still not well performed, rather it is often replaced by the improper use of gloves. Microbial transmission is estimated to occur in one-fifth of all contact cases. Objective: To investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals. Furthermore, to correlate the consumption data of the hydroalcoholic solution and the amount of antibiotics used for the treatment of hospital-acquired infections. Method: The study was conducted over six months period (from January to June 2018); during this period, 20 monitoring sessions were performed. The following indicators were evaluated: a) Non-adherence to hand hygiene with concomitant use of gloves; b) Adhesion to alcoholic friction of hands; c) Hand-washing adhesion. Instead, the consumption data, provided by the hospital ward itself, were used for the evaluation of d) The antibiotics used in the treatment of hospital-acquired infections; e) The hydro-alcoholic solution used by the healthcare professionals for hand hygiene. Results: The frequency of non-adherence to hand hygiene was very high at the beginning of the study, subsequently it decreased to about a half percent to that at the initial stage. The adhesion to alcoholic friction of hands increased during the study period. Otherwise, the hand-washing adhesion slightly reduced, especially in March probably due to the recruitment of new inadequately trained nursing staff. The trend of antibiotic consumption was similar to handwashing. The consumption of hydro-alcoholic solution was very low, however over time, it increased considerably until the end of the study. Conclusion: In light of the findings from this work, it is necessary to make the hospital staff increasingly aware of the correct practice of hand hygiene and to organize training and informative sessions to promote the health of the individual and the community.

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ATTITUDE AND PRACTICING BEHAVIOUR AMONG HEALTHCARE PROFESSIONALS REGARDING HANDWASHING:A TOOL TO PREVENT EMERGING AND RE-EMERGING INFECTIONS.

10.36106/ijsr/5813050 ◽

2020 ◽

pp. 1-3

Author(s):

Syed Waseem Tahir ◽

Sahila Nabi ◽

Shazia Javaid

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Health Professionals ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Hand Washing ◽

Emerging Infections ◽

Cross Sectional ◽

Attitude And Practice

Background: Hand hygiene is one of the most effective ways to control health care related infection. Every year millions of patients around the world are affected by infections that are transmitted by the health-care professionals(HCPs).(2)(3). Rationale: Nurses and physicians are the main health care workers contacting with patients, representing the vector in the chain of infection. Thus, assessing their knowledge, attitude and practice regarding hand hygiene is very important to decrease the incidence of health care related infection and to improve quality of care. Objective: The objective of our study was to assess the knowledge, attitude and practices of handwashing among healthcare professionals of Kashmir Division. Methods: This study was an institutional based cross sectional study, conducted in various healthcare institutions of Kashmir Division which were selected randomly. A predesigned questionnaire was used to collect the data from the participants. The questionnaires contained questions about four different parts which included sociodemographic characteristics, knowledge of hand washing, attitude and practice of hand washing among healthcare professionals. The questionnaires were distributed to various healthcare professionals working in wards, emergency department, laboratories, outpatient departments, injection and dressing rooms, EPI unit and others. The distributed questionnaires were then collected back. Results: A total of 110 participants were included. Out of total 110 participants,53% were male ,36% were nurses 36% of health professionals were working in IPD (In Patient Department). 89% of the participants agreed that, direct or indirect contacts are the most important routes for transmission of hospital-acquired infections,97% agreed that  proper and consistent hand washing prevents infections in health facilities,100% agreed that health professionals should always wash their hands immediately when they arrive at health institutions,98% said that they knew steps of handwashing(WHO)/rules of hand hygiene,91% agreed that hand washing is the single most effective mechanism to prevent spread of infection and 95% agreed that wearing jewellery, artificial fingernails, damaged skin and regular use of hand cream are associated with increased likelihood of colonisation of hands with harmful germs. 83% of the participants said that they are committed to the proper rules of hand hygiene all the time,78% said they comply with rules of hand hygiene even in emergencies,80% said that they think when they are wearing gloves it is not necessary to wash hands,92% feel irritated when others don’t follow hand hygiene rules,95% advice others to follow the rules of hand hygiene and 97% said it is easy for you to follow rules of hand hygiene. 40%(each) of the participants said that they always and usually wash hands before touching a patient,100% of the participants said that they always wash hands before performing aseptic and clean procedures, 100% of the participants said that they always wash hands after being at risk of exposure to body fluids and 95% of patients said that they wash hands after coming to and before leaving the hospital. DISCUSSION In this study we had a total of 110 participants. Health professionals had a satisfactory knowledge of hand hygiene but some lacunae are still there as is evident in the result part. Thus from this study we conclude adherence to handwashing is lacking among health professionals, so we need to have regular handwashing sessions for health professionals which will regularly sensitize them, also we need to address the reasons of this poor adherence both at the administrative and personal level. We also recommend to conduct more studies in this field so as to highlight the shortcomings in hand hygiene and then to improve upon them.

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A Human Factors Intervention in a Hospital - Evaluating the Outcome of a TeamSTEPPS Program in a Surgical Ward

10.21203/rs.3.rs-19991/v2 ◽

2020 ◽

Author(s):

Oddveig Reiersdal Aaberg ◽

Marie Louise Hall-Lord ◽

Sissel Iren Eikeland Husebø ◽

Randi Ballangrud

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Safety Culture ◽

Healthcare Professionals ◽

Patient Safety Culture ◽

Organizational Outcomes ◽

Team Training ◽

Training Intervention ◽

Surgical Ward ◽

Professional Outcomes

Abstract Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study.Methods: This study had a pre-post design with measurements at baseline and after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders’ willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data.Results: After six months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions “Mutual Support” was associated with the Patient Safety Grade, after 12 months of intervention.Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.Trial registration number: ISRCTN13997367 (retrospectively registered)

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