Improving hand hygiene compliance among healthcare workers in intensive care unit: an interventional study

Background: Hand hygiene (HH) is one of the most important measures to prevent healthcare-associated infections. The objective of the study was to assess the effectiveness of the augmented multi-interventional approaches on HH compliance rate among intensive care unit (ICU) healthcare workers (HCWs) of Farwaniya Hospital, Kuwait.Methods: An interventional study was conducted in four phases throughout eight months among adult ICU HCWs. First; HCWs, HH compliance rates and alcohol-based hand rub consumption rate (ABHR) were assessed secondly; an augmented multi-interventional approach was implemented, which included administrative support, observation and reporting, education & training, recruiting champions, and maintenance of HH supplies & reminders. Then a washout phase. Finally, re-assessment of HH compliance rates and ABHR.Results: Following the interventions, the overall HCWs’ HH compliance rate increased significantly from 58.81% to 73.17% (p=0.000), for doctors (39.82% vs. 64.93%) and nurses (68.24% vs. 80.18%), p>0.001. Significant improvement of HH compliance rates for most of HH moments, after moments were higher than before moments, p=0.000. ABHR increased significantly from 77.45 ml to 133.33 ml per patient day (95% CI=54.37-57.39, p<0.0001).Conclusions: The applied augmented multi-interventional approach was effective in improving HH compliance rates among ICU HCWs. Sustainability is warranted by continues implementation of this approach.

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Hand hygiene compliance in the intensive care unit of the Onderstepoort Veterinary Academic Hospital.

10.21203/rs.2.17130/v1 ◽

2019 ◽

Author(s):

Dikeledi Carol Sebola ◽

Charlie Boucher ◽

Caroline Maslo ◽

Daniel Nenene Qekwana

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Infection Prevention And Control ◽

Patient Contact ◽

Academic Hospital ◽

Hand Wash ◽

Hygiene Compliance

Abstract Hand hygiene compliance remains the cornerstone of infection prevention and control (IPC) in healthcare facilities. However, there is a paucity of information on the level of IPC in veterinary health care facilities in South Africa. Therefore, this study evaluated hand hygiene compliance of healthcare workers and visitors in the intensive care unit (ICU) at the Onderstepoort Veterinary Academic Hospital (OVAH). Method: A cross-sectional study was conducted among healthcare workers (HCWs) and visitors in the ICU using the infection control assessment tool (ICAT) as stipulated by the South African National Department of Health. Direct observations using the “five hand hygiene moments” criteria as set out by the World helath Organisation were also recorded. The level of compliance and a 95% confidence interval were calculated for all variables. Results: Individual bottles of alcohol-based hand-rub solution and hand-wash basins with running water, soap dispensers, and paper towels were easily accessible and available at all times in the ICU. In total, 296 observations consisting of 734 hand hygiene opportunities were recorded. Hand hygiene compliance was also evaluated during invasive (51.4%) and non-invasive (48.6%) procedures. The overall hand hygiene compliance was 24.3% (178/734). In between patients, most HCWs did not sanitize stethoscopes, leashes, and cellular phones used. Additionally, the majority of HCWs wore jewellery below the elbows. The most common method of hand hygiene was hand-rub (58.4%), followed by hand-wash (41.6%). Nurses had a higher (44%) level of compliance compared to students (22%) and clinicians (15%). Compliance was also higher after body fluid exposure (42%) compared to after patient contact (32%), before patient contact (19%), after contact with patient surroundings (16%), and before an aseptic procedure (15%). Conclusion: Hand hygiene compliance in this study was low, raising concerns of potential transmission of hospital-acquired infections and zoonoses in the ICU. Therefore, it is essential that educational programs be developed to address the low level of hand hygiene in this study.

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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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Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10916 ◽

2019 ◽

Vol 13 (08) ◽

pp. 744-747 ◽

Cited By ~ 1

Author(s):

Uluhan Sili ◽

Pinar Ay ◽

Huseyin Bilgin ◽

Seyhan Hidiroglu ◽

Volkan Korten

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

University Hospital ◽

World Health ◽

Training Methods ◽

Cross Sectional

Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for “before clean/aseptic procedure” indication and highest compliance was 68.6% for “after touching a patient” indication. Although > 90% healthcare workers correctly identified the World Health Organization’s five indications for HH, 82 – 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.

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Healthcare Workers Knowledge, Attitude, and Availability of Facilities Toward Compliance Hand Hygiene

Indonesian Journal of Global Health Research ◽

10.37287/ijghr.v1i1.2 ◽

2019 ◽

Vol 1 (1) ◽

pp. 13-20

Author(s):

Richa Noprianty ◽

Gendis Kintan Dwi Thahara

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Sampling Method ◽

Compliance Rate ◽

Sample Selection ◽

The United States ◽

Cross Sectional ◽

Knowledge And Attitude ◽

Hygiene Compliance ◽

Healthcare Associated

Failure to perform good hand hygiene is considered as an major cause of Healthcare Associated Infections (HAIs). From the WHO data, compliance rate of nurses hand hygiene activity at the United States is about 50%, Australia 65% while in Indonesia 47%. This study aims to determine healthcare workers knowledge, attitude, and availability of facilities toward that affect hand hygiene compliance. This research method is analytical descriptive with cross-sectional approach. The object of data collection is an healthcare workers (nurse, doctor, and pharmacy) at General Hospitalin West Java as many as 51 samples. Sample selection using stratified sampling method with research instrument in the form of questionnaire and observation sheet about knowledge and attitude to hand hygiene adopted from WHO. The results of this study that obtained in the group of nurse were 48.6% doing imperfect hand hygiene and group of doctor respectively 80.0% and pharmacy were 100.0%. In terms of nurses knowledge about hand hygiene is 59.5%, doctor80.0% and pharmacy 50.0%. In terms of attitudes about the implementation of hand hygiene, the nurses group is 48.6%, doctors respectively 40% and pharmacy 50.00% have a positive attitude. In terms of facilities is 40.5% nurses stated available, doctors 20% and pharmacy 0.00%. There was a significant relationship between hand hygiene with knowledge (p = 0,019), attitude (0.004) and hand hygiene facility (p = 0.040). Keywords: attitude, hand hygiene, health care, knowledge

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THE RESEARCH OF THE STATUS OF HAND HYGIENE COMPLIANCE AMONG STAFF IN ACTIVE ANTIPOOXICICURATOR DEPARTMENT IN LAM DONG II HOSPITAL IN 2019

Tạp chí Y học Cộng đồng ◽

10.52163/jcm.v62i5.152 ◽

2021 ◽

Vol 62 (5) ◽

Author(s):

Nguyen Thi Huong ◽

Tran Mai Anh ◽

Tran Van Ngoc ◽

Vu Thai Son ◽

Tran Thi Thu Thuy

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Health Workers ◽

Compliance Rate ◽

Hospital Patients ◽

The Status ◽

Hospital Acquired Pneumonia ◽

Hygiene Compliance ◽

Hospital Acquired

The research was carried out at Lam Dong II Hospital with a scale of 450 beds with the task of solving emergencies, providing medical examination and treatment for staff and people in 3 districts:Bao Loc, Da Huoai, and Di Linh. At the Intensive Care Unit - Anti-poison Department, Lam Dong II Hospital, patients have to undergo invasive procedures such as endotracheal intubation, mechanicalventilation, and the risk of hospital-acquired pneumonia is very high. To prevent people from risk, hand hygiene VST in patient care is a very important factor. The research analysis solves actual public health problems at Lam Dong II hospital with two main objectives: (1) Describe the current situation of routine hand hygiene of staff at the Intensive Care Unit - Anti-poison Department, Lam Dong II Hospital; (2) Proposing solutions to increase the hand hygiene rate among staff at the Intensive Care Unit - Anti-poison Department, Lam Dong II Hospital. Statistics show that the VST compliance rate of nurses at the Intensive Care Unit - Anti-poison Department is higher than that of doctors, nurses, the percentage of medical staff performing VSTwith quick hand sanitizer (71.8%) higher than the practice of washing hands with soap and water (28.2%), the survey results of 20 health workers showed that the knowledge about VST of the medicalstaff at the department meets the requirements of knowledge from 60% and above

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Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040607 ◽

2019 ◽

Vol 16 (4) ◽

pp. 607 ◽

Cited By ~ 6

Author(s):

Cam Le ◽

Erik Lehman ◽

Thanh Nguyen ◽

Timothy Craig

Keyword(s):

Quality Assurance ◽

Hand Hygiene ◽

Healthcare Workers ◽

Medical Center ◽

Compliance Rate ◽

World Health ◽

Limiting Factors ◽

Cultural Attitudes ◽

Knowledge And Attitude ◽

Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

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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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Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piy076 ◽

2018 ◽

Vol 8 (5) ◽

pp. 408-413 ◽

Cited By ~ 1

Author(s):

Arunava Biswas ◽

Sangeeta Das Bhattacharya ◽

Arun Kumarendu Singh ◽

Mallika Saha

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Neonatal Intensive Care Unit ◽

Conceptual Framework ◽

Neonatal Intensive Care ◽

Hand Hygiene Compliance ◽

Hand Washing ◽

Root Cause ◽

Hygiene Compliance

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.

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