scholarly journals Adherence to the five moments for hand hygiene among intensive care professionals

2015 ◽  
Vol 36 (4) ◽  
pp. 21-28 ◽  
Author(s):  
Luccas Melo de Souza ◽  
Maríndia Fernandes Ramos ◽  
Evelin Santos da Silva Becker ◽  
Lisiani Celina da Silva Meirelles ◽  
Suzana Aparecida Oliveira Monteiro

Objective: to identify the adherence of health professionals of an intensive care unit to the five moments for hand hygiene. Method: cross-sectional analytical study with a quantitative approach, based on secondary data from a database of a hospital infection control service at an institution in southern Brazil. A total of 793 observations were analyzed from July to December 2012. Results: hand washing was not performed in 446 (56.2%) of the observations, and the adherence rate was 43.7%. The greatest adherence to hand hygiene was among the physiotherapists (53.5%) and the lowest adherence was among the nursing staff (29.2%). The indications with the lowest adherence rates to hand hygiene were "before touching the patient" (18.4%) and "before aseptic procedure" (20.9%). Conclusion: we conclude that adherence to hand washing does not comply with the national and international guidelines, especially when we consider the current scenario of growing infections caused by multidrug-resistant microorganisms.

2017 ◽  
Vol 19 (2) ◽  
pp. 126
Author(s):  
Juliane De Souza Scherer ◽  
Patrícia Machado Gleit ◽  
Christian Negeliskii ◽  
André Luis Machado Bueno

Capacitação e educação são essenciais aos profissionais de saúde sobre a importância da higienização das mãos (HM) durante a assistência direta, no intuito de, constantemente, provocar reflexão e o aumento na adesão à HM. Este estudo comparou a taxa de adesão à HM, após uma campanha de capacitação em Centro de Terapia Intensiva Adulto (CTI). Foram comparadas as taxas de adesão de HM verificadas em março e junho de 2012, do CTI Adulto, respectivamente, antes e após a campanha de capacitação realizada pelo Serviço de Controle de Infecção Hospitalar nos meses de abril e maio do mesmo ano. Os resultados apontam uma maior adesão à HM pelos profissionais enfermeiros (67,57%) e fisioterapeutas (72,73%) antes da campanha. Após a campanha de educação, a resposta em relação à higiene correta pelos profissionais da enfermagem aumentou (79,31%), enquanto para os fisioterapeutas houve uma redução (56,25%) na taxa de adesão. Mesmo com todas as evidências convincentes publicadas sobre a importância da adesão à higienização de mãos no combate às infecções, ainda não se atingiu a adesão total à técnica. Portanto, a capacitação específica e periódica influência nos índices de adesão de HM e na melhoria da qualidade da assistência, resultando em maior segurança dos processos assistenciais.Palavras-chave: Desinfecção das Mãos. Controle de Infecções. Educação Continuada. Capacitação em Serviço.AbstractTraining and education are essential for health professionals on the importance of hand hygiene (HM) during direct care, in order to constantly instigate reflection and HM increase adherence. This study compared the HM adherence rate after a training campaign at the Center for Adult Intensive Care (ICU). The HM adherence rates verified in March and June 2012, respectively were compared, before and after the training campaign carried out by the Hospital Infection Control Service in April and May of the same year. The results indicate a higher nurses’ HM adherence (67.57%) and physiotherapists (72.73%) before the campaign. After the education campaign, the response to correct hygiene by nursing professionals increased (79.31%), while for physiotherapists there was a reduction (56.25%) in the adherence rate. Even with all the compelling evidence published on the importance of adherence to hand hygiene in combating infections, complete adherence to the technique has not been achieved yet. Therefore, specific and periodic training influences HM adherence rates and improves the care quality, resulting in greater security of care processes.Keywords: Hand Disinfection. Infection Control.Continuing Education. In-service Training.


2012 ◽  
Vol 1 (2) ◽  
pp. 27 ◽  
Author(s):  
Raman Sharma ◽  
Meenakshi Sharma ◽  
Vipin Koushal

Purpose: Hand hygiene is the single most important strategy to prevent HAIs. The present cross sectional study was conducted in ICUs to provide insight into the prevailing practices of hand-hygiene. Results: During two week analysis, 2400 hand washing opportunities were observed. Hand washing adherence rate was 86.0%, with highest compliance among nurses (94.0%). Compliance was (95.0%) after patient contact than 72.5% before contact. In 96.04% opportunities alcohol rub was used for hand washing. More than 90.0% staff was aware about facts viz. diseases prevented by hand washing (96.2%), ideal duration of hand washing (92.6%), reduction of HAI with hand washing (98.0%) etc. Reasons for non-adherence emerged as work pressure (94.2%) and unavailability of materials (82.4%). Conclusion The level of compliance (86%) is below the need to be there in ICU otherwise. Easy access to hand-rub solutions, adherence measurement and institutional commitment might contribute to staff sensitivity to hand hygiene practices.


2018 ◽  
Vol 8 (5) ◽  
pp. 408-413 ◽  
Author(s):  
Arunava Biswas ◽  
Sangeeta Das Bhattacharya ◽  
Arun Kumarendu Singh ◽  
Mallika Saha

Abstract Objective Our goal for this study was to quantify healthcare provider compliance with hand hygiene protocols and develop a conceptual framework for increasing hand hygiene compliance in a low-resource neonatal intensive care unit. Materials and Methods We developed a 3-phase intervention that involved departmental discussion, audit, and follow-up action. A 4-month unobtrusive audit during night and day shifts was performed. The audit results were presented, and a conceptual framework of barriers to and solutions for increasing hand hygiene compliance was developed collectively. Results A total of 1308 hand hygiene opportunities were observed. Among 1227 planned patient contacts, hand-washing events (707 [58.6%]), hand rub events (442 [36%]), and missed hand hygiene (78 [6.4%]) events were observed. The missed hand hygiene rate was 20% during resuscitation. Missed hand hygiene opportunities occurred 3.2 times (95% confidence interval, 1.9–5.3 times) more often during resuscitation procedures than during planned contact and 6.14 times (95% confidence interval, 2.36–16.01 times) more often when providers moved between patients. Structural and process determinants of hand hygiene noncompliance were identified through a root-cause analysis in which all members of the neonatal intensive care unit team participated. The mean hand-washing duration was 40 seconds. In 83% of cases, drying hands after washing was neglected. Hand recontamination after hand-washing was seen in 77% of the cases. Washing up to elbow level was observed in 27% of hand-wash events. After departmental review of the study results, hand rubs were placed at each bassinet to address these missed opportunities. Conclusions Hand hygiene was suboptimal during resuscitation procedures and between patient contacts. We developed a conceptual framework for improving hand hygiene through a root-cause analysis.


2021 ◽  
Vol 5 (2) ◽  

Introduction: The objective of this study was to evaluate the practice of hand hygiene in the maternities of the public hospitals of Lubumbashi. Method and techniques: We carried out a cross-sectional descriptive study in which the population consisted on the one hand of the technical rooms of the maternity hospitals and the operating rooms for cesarean sections and on the other hand the nurses responsible for these maternities. The observation technique using an observation guide of the WHO model allowed us to collect the data. Results: Hand hygiene was not properly carried out in the maternity wards of Lubumbashi's public hospitals. Most of the prerequisites before hand washing and hydro-alcoholic hand rubbing were not respected, the prerequisites for surgical hand washing were observed only at 21.4%:e wearing of short-sleeved clothing (43.0%),absence of jewelry (78.6%), short nails without varnish and false nails (50.0%). In the absence of hydroalcoholic solution (SHA) (71.4%) for the friction, they used denatured alcohol (28.6%). The duration of soaping and friction was in an interval between 11 to 20 seconds or 42.9% and that of hygienic hand washing was observed at 28.6%. The duration of surgical and antiseptic hand washing was 21 to 40 seconds to 35.7%. Only 21.4% of the departments surveyed had used the broad-spectrum antiseptic foaming solution, no structure had a sterile disposable brush for hygienic and surgical hand washing, 2/14 departments surveyed had sterile disposable towels, the water used had not undergone bacteriological control and only one service, ie 7.1%, which had non-manually operated bins. Conclusion: Hand hygiene is not properly carried out in maternity hospitals in Lubumbashi's public hospitals, due to a lack of equipment and knowledge on this practice, equipment must be provided and staff trained in hand hygiene.


2020 ◽  
Author(s):  
Yang Li ◽  
Hai Ge ◽  
Hui Zhou ◽  
Wanqing Zhou ◽  
Jie Zheng ◽  
...  

Abstract Objective: To continuously evaluate the effect of environmental cleaning on the colonization and infection rates of multidrug-resistant Acinetobacter baumannii (MDR-AB) in the patients within an intensive care unit (ICU). Methods: Environmental cleaning on the high-touch clinical surfaces (HTCS) within a comprehensive ICU was evaluated through monitoring fluorescent marks when the overall compliance with hand hygiene during 2013-2014 was monitored. Meanwhile, samples from the HTCS and inpatients were collected and sent for bacterial culture and identification. The drug susceptibility testing was further implemented to monitor the prevalence of MDR-AB. The genetic relatedness of MDR-AB collected either from the HTCS or inpatients was analyzed by pulsed field gel electrophoresis (PFGE) when an outbreak was doubted. Results: The overall compliance with hand hygiene remained relatively stable during 2013-2014. Under this circumstance, the clearance rate of fluorescence marks on the environmental surfaces within ICUs significantly increased from 21.9% to 85.7%, and accordingly the colonization and infection rates of MDR-AB decreased from 16.5‰ to 6.6‰ and from 7.4‰ to 2.8‰, respectively, from the beginning to the end of 2013. However, during the year 2014, because of frequent change and movement of cleaning workers, the clearance rate of fluorescence marks decreased below 50%, and the overall colonization and infection rates of MDR-AB correspondingly increased from 9.1‰ to 11.1‰ and from 1.5‰ to 3.9‰, respectively. PFGE displayed a high genetic relatedness between the MDR-AB strains analyzed, indicating a dissemination of MDR-AB during the surveillance period. Conclusion. For the easily disseminated MDR-AB within ICUs , the clearance rates of fluorescence labeling on HTCS is negatively corelated with the hospital infection rates of MDR-AB. Such an invisible fluorescence labelling is an effective and convenient method to continuously monitor cleanness of medical environment within hospitals.


2020 ◽  
Vol 14 (1) ◽  
pp. 42-48
Author(s):  
Emanuela Santoro ◽  
Marco Fiore ◽  
Sebastiano Leone ◽  
Armando Masucci ◽  
Roberta Manente ◽  
...  

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.


Author(s):  
P Ronni Mol ◽  
Ganesan Shanthi ◽  
Khalid Bindayna

Introduction: The most common pathogens causing Urinary Tract Infections (UTI) in community and hospital settings are Enterobacteriaceae. Antibiotic resistance is a major problem worldwide because of an increase in the use of antibiotics. Production of Extended Spectrum Beta-Lactamases (ESBLs) and AmpC beta-lactamases is the most common cause of resistance among Enterobacteriaceae (AmpC). Initially, AmpC β-lactamases received less attention globally, but now it has become a rising problem. Detection of AmpC β-lactamases expressing microbes is a requirement for addressing surveillance, for problems of hospital infection control, and for choosing optimal antimicrobial therapy. Aim: To study the genotype distribution of plasmid mediated AmpC β-lactamase produced in Enterobacteriaceaestrains isolated from urine samples. Materials and Methods: A cross-sectional study based on clinical laboratory surveillance was conducted from July 2019 to February 2020. Sixty Enterobacteriaceae isolates were identified by standard biochemical reactions. AmpC screening were done by cefoxitin disk diffusion and confirmed by an inhibitor-based assay using boronic acid. The presence of six plasmid mediated AmpC genes was determined by multiplex Polymerase Chain Reaction (PCR). Statistical Package for the Social Science (SPSS) version 20.0 was used to obtain descriptive data. Results: Among 60 Enterobacteriaceae isolates, 23 (38.3%) were cefoxitin-resistant isolates which contain Escherichia colistrain (n=17) while the remaining samples consist ofKlebsiella pneumoniae (n=5) and Proteus mirabilis strains (n=1). AmpC β-lactamase production was phenotypically confirmed in 12(20%) isolates and genotypically confirmed by PCR analysis in 16(26.6%) of all the urine isolates. In the present study, 3(13%), 2 (8.6%) of cefoxitin resistant isolates harboured the DHA, EBC gene and 1(4.3%) each harboured FOX and CIT gene, and 9(39.1%) harboured a combination of the genes. Conclusion: The present study suggested the predominant existence of plasmid mediated AmpC producers in Multi-Drug Resistant (MDR) Escherichia coli and Klebsiella pneumoniae. We suggest continuous surveillance is important to effectively control the spread of these strains and for optimal clinical outcome.


2020 ◽  
pp. 1-3
Author(s):  
Syed Waseem Tahir ◽  
Sahila Nabi ◽  
Shazia Javaid

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.


2018 ◽  
Vol 5 (1) ◽  
pp. 90-95
Author(s):  
Ajay Kumar Rajbhandari ◽  
Reshu Agrawal Sagtani ◽  
Kedar Prasad Baral

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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