Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.

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Hand hygiene compliance among rural healthcare workers of Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24050 ◽

2018 ◽

Vol 5 (1) ◽

pp. 90-95

Author(s):

Ajay Kumar Rajbhandari ◽

Reshu Agrawal Sagtani ◽

Kedar Prasad Baral

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Hand Washing ◽

World Health ◽

Cross Sectional ◽

Hygiene Compliance ◽

Health Organization ◽

Healthcare Associated

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).

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Compliance with Hand Hygiene and Glove Use in a University-Affiliated Hospital

Infection Control and Hospital Epidemiology ◽

10.1086/502545 ◽

2005 ◽

Vol 26 (3) ◽

pp. 312-315 ◽

Cited By ~ 55

Author(s):

Nevin Kuzu ◽

Fadime Özer ◽

Semra Aydemir ◽

Ata Nevzat Yalcin ◽

Mehmet Zencir

Keyword(s):

High Risk ◽

Hand Hygiene ◽

Nosocomial Infections ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Motivational Strategies ◽

Liquid Soap ◽

Hospital Room ◽

The Mean ◽

Hygiene Compliance

AbstractObjective:The hands of healthcare workers often transmit pathogens causing nosocomial infections. This study examined compliance with handwashing and glove use.Setting:A university-affiliated hospital.Design:Compliance was observed covertly. Healthcare workers' demographics, hand hygiene facilities, indications for hand hygiene, compliance with handwashing and glove use in each procedure, and duration of handwashing were recorded.Results:Nine nurses and 33 assistant physicians were monitored during the study. One researcher recorded 1,400 potential opportunities for handwashing during 15-minute observation periods. The mean duration of handwashing was 10 + 2 seconds. Most healthcare workers (99.3%) used liquid soap during handwashing, but 79.8% did not dry their hands. For all indications, compliance with handwashing was 31.9% and compliance with glove use was 58.8%. Compliance with handwashing varied inversely with both the number of indications for hand hygiene and the number of patient beds in the hospital room. Compliance with handwashing was better in dirty high-risk situations.Conclusion:Compliance with handwashing was low, suggesting the need for new motivational strategies such as supplying feedback regarding compliance rates.

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Appropriate Number of Observations to Determine Hand Hygiene Compliance Among Healthcare Workers

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.125 ◽

2021 ◽

Vol 1 (S1) ◽

pp. s64-s64

Author(s):

Se Yoon Park ◽

Eunjung Lee ◽

Suyeon Park ◽

Tae Hyong Kim ◽

Sungho Won

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Mean Value ◽

World Health ◽

The World ◽

Minimum Number ◽

The Mean ◽

Hygiene Compliance ◽

Health Organization

Background: We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. Methods: The study was conducted at a referral hospital. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Appropriate HH compliance rates were calculated based on the 6-step technique, modified from the World Health Organization (WHO) recommendation. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (1-α) [The equation: n3 Zα/22×ρ×1-ρ/d2]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%, respectively. Among the various cases, we focused on 10% for d and 95% for CI. Results: During the study period, 8,791 opportunities among 1,168 healthcare workers were monitored. The mean HH compliance and appropriate HH compliance rates were 80.3% and 59.7%, respectively (Table 1). The minimum number of observations required to determine HH compliance rates ranged from 2 (d, 30%; CI, 90%) to 624 (d, 5%; CI, 99%), and the minimum number of observations for optimal HH compliance ranged from 5 (d, 30%, CI, 90%) to 642 (d, 5%; CI, 99%) (Figure 1). At 10% absolute precision with 95% confidence, the minimum number of observations to determine HH and optimal HH compliance were 61 and 92, respectively. Conclusions: The minimum number of observations to determine HH compliance varies widely according to setting, but at least 5 were needed to determine optimal HH compliance.Funding: NoDisclosures: None

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Hand hygiene compliance among healthcare workers in a tertiary care academic health care organization

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20200498 ◽

2020 ◽

Vol 8 (3) ◽

pp. 878

Author(s):

Varun Goel ◽

Savita Gupta ◽

Dakshina Bisht ◽

Rashmi Sharma

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Tertiary Care ◽

High Morbidity ◽

Care Organization ◽

Who Guidelines ◽

Surgical Icu ◽

Hygiene Compliance

Background: Healthcare Associated Infections (HAIs) are a major cause of high morbidity, disability, mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Handwashing is one of the fundamental measures for preventing transmission of hospital-acquired infections.Methods: This cross-sectional observational study was conducted in the surgical ICU from January to February 2018 to evaluate the presence of adhesion to the different aspects of HH. Inclusion criteria included all nurses and allied healthcare workers of surgical ICU while all other HCWs were excluded. Two observers collected all HH data. During this analysis, 3000 HH opportunities were observed. HH compliance was tested for all 5 moments as per WHO guidelines. Data thus collected were entered into a computer-based spreadsheet for analysis using SPSS statistical software (version 20) (IBM Corp., NY, USA).Results: Overall hand hygiene compliance observed as per WHO Guidelines was 79.8%. Nurses had an adherence rate of 77.8%; allied staff adherence was 81.8%. Nurses’ compliance after touching patient surroundings was lowest at 60.7%. 96% staff was aware of the facts like diseases prevented by hand washing, ideal duration of HH, reduction of health care associated infections.Conclusions: Overall, the involved ICUs showed low levels of adherence to best hygiene practices with overall compliance of 79.2%. This suggests the need to implement immediate strategies for infection control in the ICUs. A multidisciplinary intervention could be effective in preventing and control the HAI risk.

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A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-017-0268-y ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 5

Author(s):

Tufa Kolola ◽

Takele Gezahegn

Keyword(s):

Health Care ◽

Observational Study ◽

Hand Hygiene ◽

Health Care Workers ◽

Hand Hygiene Compliance ◽

Referral Hospital ◽

Care Workers ◽

Debre Berhan ◽

Hygiene Compliance

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Improving Children’s and Their Visitors’ Hand Hygiene Compliance

10.1101/355818 ◽

2018 ◽

Author(s):

D. Lary ◽

A. Calvert ◽

B. Nerlich ◽

J. Segal ◽

N. Vaughan ◽

...

Keyword(s):

Observational Study ◽

Hand Hygiene ◽

Educational Intervention ◽

Body Fluid ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Qualitative Data ◽

Educational Interventions ◽

Before And After ◽

Hygiene Compliance

AbstractBackgroundNumerous interventions have tried to improve healthcare workers’ hand hygiene compliance, however little attention has been paid to children’s and their visitors’ compliance.AimTo increase children’s and visitors’ compliance using interactive educational interventions.MethodsThis was an observational study of hand hygiene compliance before and after the introduction of educational interventions. Qualitative data in the form of Questionnaires and interviews was obtained.FindingsHand hygiene compliance increased by 21.4% (P <0.001) following the educational interventions, with children’s compliance reaching 40.8% and visitors’ being 50.8%. Compliance varied depending on which of the ﬁve moments of hygiene was observed (P<0.001), with the highest compliance after body ﬂuid exposure (96%). Responses from questionnaires showed educational interventions raised awareness of the importance of hand hygiene (69%, 57%) compared to those who had not experienced the educational intervention (50%).ConclusionEducational interventions may result in a significant increase in children’s and visitors’ hand hygiene (P <0.001).

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Hand hygiene and the sequence of patient care

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.82 ◽

2021 ◽

pp. 1-6

Author(s):

Nai-Chung Chang ◽

Michael Jones ◽

Heather Schacht Reisinger ◽

Marin L. Schweizer ◽

Elizabeth Chrischilles ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Patient Care ◽

Intensive Care Units ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Resistant Bacteria ◽

Surgical Intensive Care ◽

Hygiene Compliance ◽

Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

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Intranasal Antiseptic and Universal Antiseptic Baths Are Effective in Reducing MRSA Acquisition in Extended-Care Facilities

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.888 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s304-s305

Author(s):

Angela Chow ◽

Wei Zhang ◽

Joshua Wong ◽

Brenda Ang

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Compliance Rate ◽

Care Facility ◽

Clinical Problem ◽

Clinical Samples ◽

Extended Care ◽

Care Facilities ◽

The Mean ◽

Hygiene Compliance

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing clinical problem in rehabilitation hospitals, where patients stay for extended periods for intensive rehabilitation therapy. In addition to cutaneous sites, the nares could be a source for nosocomial MRSA transmission. Decolonization of nasal and cutaneous reservoirs could reduce MRSA acquisition. We evaluated the effectiveness of topical intranasal octenidine gel, coupled with universal chlorhexidine baths, in reducing MRSA acquisition in an extended-care facility. Methods: We conducted a quasi-experimental before-and-after study from January 2013 to June 2019. All patients admitted to a 100-bed rehabilitation hospital specialized in stroke and trauma care in Singapore were screened for MRSA colonization on admission. Patients screened negative for MRSA were subsequently screened at discharge for MRSA acquisition. Screening swabs were obtained from the nares, axillae, and groin and were cultured on selective chromogenic agar. Patients who tested positive for MRSA from clinical samples collected >3 days after admission were also considered to have hospital-acquired MRSA. Universal chlorhexidine baths were implemented throughout the study period. Intranasal application of octenidine gel for MRSA colonizers for use for 5 days from admission was added to the hospital’s protocol beginning in September 2017. An interrupted time series with segmented regression analysis was performed to evaluate the trends in MRSA acquisition before the intervention (January 2013–July 2017) and after the intervention (September 2017–June 2019) with intranasal octenidine. August 2017 was excluded from the analysis because the intervention commenced midmonth. Results: In total, 77 observational months (55 before the intervention and 22 after the intervention) were included. The mean monthly MRSA acquisition rates were 7.0 per 1,000 patient days before the intervention and 4.4 per 1,000 patient days after the intervention (P < .001), with a mean number of patient days of 2,516.3 per month before the intervention and 2,427.2 per month after the intervention (P = .0172). The mean monthly number of MRSA-colonized patients on admission to the hospital decreased from 24.8 before the intervention to 18.7 after the intervention (P < .001). Mean monthly hand hygiene compliance rate increased significantly from 65.7% before the intervention to 87.4% after the intervention (P < .001). After adjusting for the number of MRSA-colonized patients on admission and hand hygiene compliance rates, a constant trend was observed from January 2013 to July 2017 (adjusted mean coefficient, 0.012; 95% CI, −0.037 to 0.06), with an immediate drop in September 2017 (adjusted mean coefficient, −2.145; 95% CI, −0.248 to −0.002; P = .033), followed by a significant reduction in MRSA acquisition after the intervention from September 2017 through June 2019 (adjusted mean coefficient, −0.125; 95% CI, -4.109 to -0.181; P = .047). Conclusions: Topical intranasal octenidine, coupled with universal chlorhexidine baths, can reduce MRSA acquisition in extended-care facilities. Further studies should be conducted to validate the findings in other healthcare settings.Funding: NoneDisclosures: None

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