scholarly journals Identification of factors associated with hand hygiene adherence as a support for creating curriculum for nurses training – a multivariate analysis

2020 ◽  
Vol 89 (3) ◽  
pp. e444
Author(s):  
Anna Garus-Pakowska

Aim. Handwashing is the easiest way to prevent infection but is often neglected. The purpose of the study was to identify the barriers limiting the respect for hygiene procedures by nurses. Material and Methods. The study involved direct quasi-participant observation and a questionnaire of 11 nurses in six wards of three hospitals in Poland. Results. In total,1,195 observations were conducted in which 3,355 activities requiring hygiene procedures were observed over 8 months. The nurses’ knowledge of proper hand hygiene and infection prevention principles were unsatisfactory, with an average value of correct answers in the knowledge test of 8.7 (Max = 15). The univariate analysis indicated the following barriers in hand hygiene: emergencies, allergies, or too few dispensers. In multivariate analysis, the application of hygiene procedures depended on the level of education (higher education – worse compliance with the rules) and subjective conviction that handwashing/glove use was important. Conclusion. Educational programmes on hand hygiene should focus on the World Health Organisation indications that glove use is not a substitute for handwashing.

2015 ◽  
Vol 73 (9) ◽  
pp. 770-778 ◽  
Author(s):  
Benedicto Oscar Colli ◽  
Carlos Gilberto Carlotti Junior ◽  
João Alberto Assirati Junior ◽  
Vicente de Paulo Martins Coelho Junior ◽  
Luciano Neder

Atypical/anaplastic (World Health Organization (WHO) grades II and III) are less common and have poorer outcomes than benign meningiomas. This study aimed to analyze the outcome of patients with these tumors.Method Overall/recurrence-free survivals (RFS) and the Karnofsky Performance Scale of 52 patients with grades II (42) and III (9) meningiomas surgically treated were analyzed (uni/multivariate analysis).Results Total/subtotal resections were 60.8%/35.3%. Patients <60 years-old and grade II tumors had longer survival. Grade II tumors, total resection andde novo meningioma had better RFS (univariate analysis). Patients >60 years-old, de novo meningioma and radiotherapy had longer survival and patients <60 years-old and with grade II tumors had longer RFS (multivariate analysis). Recurrence rate was 51% (39.2% Grade II and 66.7% Grade III). Operative mortality was 1.9%.Conclusion Age <60 years-old, grade II tumors and de novomeningiomas were the main predictors for better prognosis among patients with grades II and III meningiomas.


Author(s):  
Gerard Lacey ◽  
Lucyna Gozdzielewska ◽  
Kareena McAloney-Kocaman ◽  
Jonathan Ruttle ◽  
Sean Cronin ◽  
...  

AbstractHand hygiene is critical for infection control, but studies report poor transfer from training to practice. Hand hygiene training in hospitals typically involves one classroom session per year, but psychomotor skills require repetition and feedback for retention. We describe the design and independent evaluation of a mobile interactive augmented reality training tool for the World Health Organisation (WHO) hand hygiene technique. The design was based on a detailed analysis of the underlying educational theory relating to psychomotor skills learning. During the evaluation forty-seven subjects used AR hand hygiene training over 4 weeks. Hand hygiene proficiency was assessed at weekly intervals, both electronically and via human inspection. Thirty eight participants (81%) reached proficiency after 24.3 (SD = 17.8) two-minute practice sessions. The study demonstrated that interactive mobile applications could empower learners to develop hand hygiene skills independently. Healthcare organizations could improve hand hygiene quality by using self-directed skills-based training combined with regular ward-based assessments.


Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  

Abstract Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.


2019 ◽  
Author(s):  
Anthony Devlin ◽  
Courtney J. Mycroft-West ◽  
Marco Guerrini ◽  
Edwin A. Yates ◽  
Mark A. Skidmore

AbstractThe widely used anticoagulant pharmaceutical, heparin, is a polydisperse, heterogeneous polysaccharide. Heparin is one of the essential medicines defined by the World Health Organisation but, during 2007-2008, was the subject of adulteration. The intrinsic heterogeneity and variability of heparin makes it a challenge to monitor its purity by conventional means. This has led to the adoption of alternative approaches for its analysis and quality control, some of which are based on multivariate analysis of 1H NMR spectra, or exploit correlation techniques. Such NMR spectroscopy-based analyses, however, require costly and technically demanding NMR instrumentation. Here, an alternative approach based on the use of attenuated total reflectance Fourier transform infrared spectroscopy (FTIR-ATR) combined with multivariate analysis is proposed. FTIR-ATR employs more affordable and easy-to-use technology and, when combined with multivariate analysis of the resultant spectra, readily differentiates between glycosaminoglycans of different types, between heparin samples of distinct animal origins and enables the detection of both known heparin contaminants, such as over-sulphated chondroitin sulfate (OSCS), as well as other alien sulphated polysaccharides in heparin samples to a degree of sensitivity comparable to that achievable by NMR. The approach will permit the rapid and cost-effective monitoring of pharmaceutical heparin at any stage of the production process and indeed, in principle, the quality control of any heterogeneous or variable material.


Author(s):  
Anna Deryabina ◽  
Meghan Lyman ◽  
Daiva Yee ◽  
Marika Gelieshvilli ◽  
Lia Sanodze ◽  
...  

Abstract Background The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.


2020 ◽  
Author(s):  
Anna Deryabina ◽  
Meghan Lyman ◽  
Daiva Yee ◽  
Marika Gelieshvilli ◽  
Lia Sanodze ◽  
...  

Abstract Background The Georgia Ministry of Labor, Health, and Social Affairs (MoLHSA) is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2017, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.


Author(s):  
Giorgia Gon ◽  
Sandra Virgo ◽  
Mícheál de Barra ◽  
Said M. Ali ◽  
Oona M. Campbell ◽  
...  

Recent research calls for distinguishing whether the failure to comply with World Health Organisation hand hygiene guidelines is driven by omitting to rub/wash hands, or subsequently recontamination of clean hands or gloves prior to a procedure. This study examined the determinants of these two behaviours. Across the 10 highest-volume labour wards in Zanzibar, we observed 103 birth attendants across 779 hand hygiene opportunities before aseptic procedures (time-and-motion methods). They were then interviewed using a structured cross-sectional survey. We used mixed-effect multivariable logistic regressions to investigate the independent association of candidate determinants with hand rubbing/washing and avoiding glove recontamination. After controlling for confounders, we found that availability of single-use material to dry hands (OR:2.9; CI:1.58–5.14), a higher workload (OR:29.4; CI:12.9–67.0), more knowledge about hand hygiene (OR:1.89; CI:1.02–3.49), and an environment with more reminders from colleagues (OR:1.20; CI:0.98–1.46) were associated with more hand rubbing/washing. Only the length of time elapsed since donning gloves (OR:4.5; CI:2.5–8.0) was associated with avoiding glove recontamination. We identified multiple determinants of hand washing/rubbing. Only time elapsed since washing/rubbing was reliably associated with avoiding glove recontamination. In this setting, these two behaviours require different interventions. Future studies should measure them separately.


2014 ◽  
Vol 4 (8) ◽  
pp. I
Author(s):  
R Baral

Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs) while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC). If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation). Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs) which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW), visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more effective since the best practices are the same for all hospitals and this helps in standardizing the policies. There are organizations which work in promoting IPAC through education, standards, and advocacy and consumer awareness. Examples of organizations working in this field are IPAC Canada, Centers for Disease Control and Prevention (CDC) USA, Infection Prevention Society UK, Asia Pacific Society of Infection Control (APSIC), World Health Organization (WHO). In Nepal organizational initiation to address the issues of IPAC has been recently taken by Healthy Life Foundation Nepal (HELF Nepal) which is an organization with the mission to inform, promote and implement best practices of IPAC to prevent HAIs in the patients as well as the healthcare workers in all healthcare settings in Nepal.In Nepal awareness on IPAC in Pathology Laboratories can be brought about by initiating trainings, surveillance, regular CMEs and demonstration of techniques to the Lab personnel. Administration will have to be involved in initiating the program and maintaining it with administrative resources and financial support. Before it is too late we have to address the issues of HAIs, AROs and safety in our laboratories.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11603


1970 ◽  
Vol 7 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Shafquat Inayat ◽  
Shahina Pirani ◽  
Tazeen Saeed Ali ◽  
Uzma Rahim Khan ◽  
Josefin Särnholm

Background: Physical violence is considered as a routine matter and is a neglected issue in the heavily populated society of Pakistan. The study aimed to estimate the physical violence and its associated factors among married women living in the district Multan, a city of Southern Punjab, Pakistan. Methods: A Cross-Sectional study was conducted among 375 married women living in the community of six towns of Multan. The data was collected from March 2013 to May 2013, through a questionnaire, based on the World Health Organization Multi-country Study on Women's Health and Life Experiences of Violence against Women. A univariate and multivariate analyses were recorded. Results: Out of 375 women surveyed, 62.93% reported physical violence. In the univariate analysis, women's age (28-60 years), women's occupation (non-professional,) and family categories, (combined/extended) were found to be significant, at 95% confidence interval (CI). In multivariate analysis, women's employment status, as non-earning (OR; 0.57CI:0.33, 0.98) was significant in last year, and in life time multivariate analysis, husband's nonprofessional status (OR; 1.06; CI: 0.635 1, 0.793) and women's non-earning status (OR; 0.57; CI: 0.33, 0.98) became significant. The combined family system (OR; 1.795, CI: 1.120, 2.878) was found to be significant in multivariate analyses. Conclusion: Physical violence of different forms is considered as a social and cultural norm by intimate partner. There is a pressing need for appropriate mechanisms particularly in primary health care, to identify and deal with physical violence


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