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

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.

scholarly journals Hand hygiene and the sequence of patient care

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.

scholarly journals Access to Alcohol-Based Hand Rub Is Associated With Improved Hand Hygiene in an Ebola-Threatened District of Western Uganda

2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Wide Distribution ◽  
Patient Contact ◽  
Improve Hand Hygiene ◽  
Before And After ◽  
Hygiene Compliance ◽  
Handwashing With Soap

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan

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

2018 ◽  
Vol 8 (5) ◽  
pp. 408-413 ◽  
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.

Self-Protection as a Driver for Hand Hygiene Among Healthcare Workers

2009 ◽  
Vol 30 (6) ◽  
pp. 578-580 ◽  
Author(s):  
Michael A. Borg ◽  
Mohamed Benbachir ◽  
Barry D. Cookson ◽  
Saida Ben Redjeb ◽  
Ziad Elnasser ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Patient Contact ◽  
Self Assessment ◽  
Mediterranean Countries ◽  
Hygiene Compliance ◽  
Self Protection ◽  
Assessment Questionnaire

A total of 2,725 healthcare workers in 8 Mediterranean countries replied to a self-assessment questionnaire that assessed their perceptions on hand hygiene. Responses revealed that rates of hand hygiene compliance before patient contact were significantly less than rates after patient contact (P < .001) and that use of soap and water was preferred over use of alcohol-based hand rub. These findings suggest that self-protection could be a major subliminal driver for performance of hand hygiene.

scholarly journals A spatiotemporal simulation study on the transmission of harmful microorganisms through connected healthcare workers in a hospital ward setting

2020 ◽  
Author(s):  
Magnus J. M. van Niekerk ◽  
Alfred A. Stein ◽  
Edwina M. H. E. Doting ◽  
Mariëtte M. Lokate ◽  
Annemarie L. M. A. Braakman-Jansen ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Worker ◽  
Radio Frequency Identification ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Infection Prevention And Control ◽  
Transmission Potential ◽  
Occupation Group ◽  
Frequency Identification ◽  
Hygiene Compliance

Abstract Background: Transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against the transmission and spread of harmful microorganisms is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time. The spatiotemporal effects on the transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance are unknown. The objectives of this study are to (1) identify a healthcare worker occupancy group of potential super-spreaders and (2) quantify spatiotemporal effects on the transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance caused by this group.Methods: Spatiotemporal data were collected in a ward of an academic hospital using radio frequency identification technology for seven days. A potential super-spreader healthcare worker occupation group was identified using the contact data derived from the frequency identification sensors. The effects of five probability distributions of hand hygiene compliance and three rates of harmful microorganism transmission were simulated using a dynamic agent-based simulation model. The effects of initial simulation assumptions on the simulation results were quantified using five risk factors.Results: Nurses, doctors and patients are together responsible for 78.8% of all contacts. Nurses made up 57% of all contacts, which is more than five times that of doctors (11.1%). This identifies nurses as the potential super-spreader healthcare worker occupation group. For initial simulation conditions of extreme lack of hand hygiene compliance (5%) and high transmission rates (5% per contact moment), a colonized nurse can transfer microbes to three of the 17 healthcare worker or patients encountered during the 87 minutes of visiting 22 rooms while colonized. The harmful microorganism transmission potential for nurses is higher during weeknights (5 pm – 7 am) and weekends as compared to weekdays (7 am – 5 pm). Conclusion: Spatiotemporal behaviour and social mixing patterns of healthcare can change the expected number of transmissions and spread of harmful microorganism by super-spreaders in a closed healthcare setting. These insights can be used to develop better-informed infection prevention and control strategies.

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