scholarly journals Assessing Hand Hygiene and Low-Level Disinfection of Equipment Compliance in an Acute Care Setting: Mixed Methods Approach (Preprint)

2020 ◽  
Author(s):  
Hammad Akram ◽  
Alison Andrews-Paul ◽  
Rachel Washburn
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Peer Pressure ◽  
Mixed Methods Approach ◽  
Hand Sanitizer ◽  
Low Level ◽  
Hygiene Compliance ◽  
Evening Shift ◽  
Morning Shift

BACKGROUND Hand hygiene and low-level disinfection of equipment behaviors among hospital staff are some of the leading cost-effective methods to reduce hospital-acquired infections (HAI) among patients. OBJECTIVE The aim of this study is to examine hand hygiene and low-level disinfection of equipment practices in a central Texas hospital and to explore pertaining gaps, perceptions, and challenges. METHODS Data were collected using a multipronged mixed methods approach that included the following: (1) observation of hand hygiene and low-level disinfection practices (12 and 8 units during morning and evening shifts, respectively); (2) observation of usability/placement of hand sanitizer dispensers; (3) semistructured interviews; and (4) a follow-up email survey. RESULTS In total, 222 (156 morning shift and 66 evening shift) staff members were observed. Of 526 hand hygiene and 33 low-level disinfection opportunities, compliance was observed 410 (78%) and 17 (51%) times, respectively. Overall, 6 units (50%) had ≥0.80 (favorable) hand hygiene compliance during the morning shift and 2 units (25%) had ≥0.80 hand hygiene compliance during the evening shift. Aggregated low-level disinfection compliance was 0.54 during the morning and 0.33 during the evening. Overall, the odds of noncompliant hand hygiene behavior were 1.4 times higher among staff who worked during night shifts compared to day shifts; however, this relationship was not statistically significant (95% CI 0.86-2.18; <i>P</i>=.18). Noncompliant behavior was most likely among unit B staff during the evening; however, this relationship was not statistically significant (OR 5.3, 95% CI 0.84-32.9; <i>P</i>=.07) All units, except one, had similar hand sanitizer dispenser usability characteristics. In the qualitative part of the study, the following challenges were identified: “shortage of time while seeing patients,” “sometimes the staff forgets,” “concern about drying hands,” “behavior is difficult or requires reminders,” and “there may be issues with resources or access to supplies to perform these behaviors.” Staff also stated that “a process that is considered effective is the Stop the Line program,” and that the “behavior is easy and automatic.” CONCLUSIONS Hand hygiene and low-level disinfection compliance is dependent on several personal and nonpersonal factors. Issues such as time constraints, peer pressure, work culture, available resources, and understanding of guidelines could influence staff behavior. The information collected through this study can be used to re-examine similar or related issues at a larger scale.

scholarly journals Assessing Hand Hygiene and Low-Level Disinfection of Equipment Compliance in an Acute Care Setting: Mixed Methods Approach

JMIR Nursing ◽  
10.2196/18788 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e18788
Author(s):  
Hammad Akram ◽  
Alison Andrews-Paul ◽  
Rachel Washburn
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Peer Pressure ◽  
Mixed Methods Approach ◽  
Hand Sanitizer ◽  
Low Level ◽  
Hygiene Compliance ◽  
Evening Shift ◽  
Morning Shift

Background Hand hygiene and low-level disinfection of equipment behaviors among hospital staff are some of the leading cost-effective methods to reduce hospital-acquired infections (HAI) among patients. Objective The aim of this study is to examine hand hygiene and low-level disinfection of equipment practices in a central Texas hospital and to explore pertaining gaps, perceptions, and challenges. Methods Data were collected using a multipronged mixed methods approach that included the following: (1) observation of hand hygiene and low-level disinfection practices (12 and 8 units during morning and evening shifts, respectively); (2) observation of usability/placement of hand sanitizer dispensers; (3) semistructured interviews; and (4) a follow-up email survey. Results In total, 222 (156 morning shift and 66 evening shift) staff members were observed. Of 526 hand hygiene and 33 low-level disinfection opportunities, compliance was observed 410 (78%) and 17 (51%) times, respectively. Overall, 6 units (50%) had ≥0.80 (favorable) hand hygiene compliance during the morning shift and 2 units (25%) had ≥0.80 hand hygiene compliance during the evening shift. Aggregated low-level disinfection compliance was 0.54 during the morning and 0.33 during the evening. Overall, the odds of noncompliant hand hygiene behavior were 1.4 times higher among staff who worked during night shifts compared to day shifts; however, this relationship was not statistically significant (95% CI 0.86-2.18; P=.18). Noncompliant behavior was most likely among unit B staff during the evening; however, this relationship was not statistically significant (OR 5.3, 95% CI 0.84-32.9; P=.07) All units, except one, had similar hand sanitizer dispenser usability characteristics. In the qualitative part of the study, the following challenges were identified: “shortage of time while seeing patients,” “sometimes the staff forgets,” “concern about drying hands,” “behavior is difficult or requires reminders,” and “there may be issues with resources or access to supplies to perform these behaviors.” Staff also stated that “a process that is considered effective is the Stop the Line program,” and that the “behavior is easy and automatic.” Conclusions Hand hygiene and low-level disinfection compliance is dependent on several personal and nonpersonal factors. Issues such as time constraints, peer pressure, work culture, available resources, and understanding of guidelines could influence staff behavior. The information collected through this study can be used to re-examine similar or related issues at a larger scale.

Hand sanitizer-dispensing door handles increase hand hygiene compliance: A pilot study

2014 ◽  
Vol 42 (4) ◽  
pp. 443-445 ◽  
Author(s):  
Lukasz S. Babiarz ◽  
Brent Savoie ◽  
Mark McGuire ◽  
Lauren McConnell ◽  
Paul Nagy
Keyword(s):  
Pilot Study ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Hand Sanitizer ◽  
Hygiene Compliance

scholarly journals Hand hygiene during facility-based childbirth in Cambodia: a theory-driven, mixed-methods observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yolisa Nalule ◽  
Helen Buxton ◽  
Por Ir ◽  
Supheap Leang ◽  
Alison Macintyre ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Night Shift ◽  
Formative Research ◽  
Health Care Facilities ◽  
Environmental Drivers ◽  
Birth Attendants ◽  
Hygiene Practices ◽  
Hygiene Compliance

Abstract Background Despite current efforts to improve hand hygiene in health care facilities, compliance among birth attendants remains low. Current improvement strategies are inadequate, largely focusing on a limited set of known behavioural determinants or addressing hand hygiene as part of a generalized set of hygiene behaviours. To inform the design of a facility –based hand hygiene behaviour change intervention in Kampong Chhnang, Cambodia, a theory-driven formative research study was conducted to investigate the context specific behaviours and determinants of handwashing during labour and delivery among birth attendants. Methods This formative mixed-methods research followed a sequential explanatory design and was conducted across eight healthcare facilities. The hand hygiene practices of all birth attendants present during the labour and delivery of 45 women were directly observed and compliance with hand hygiene protocols assessed in analysis. Semi-structured, interactive interviews were subsequently conducted with 20 key healthcare workers to explore the corresponding cognitive, emotional, and environmental drivers of hand hygiene behaviours. Results Birth attendants’ compliance with hand hygiene protocol was 18% prior to performing labour, delivery and newborn aftercare procedures. Hand hygiene compliance did not differ by facility type or attendants’ qualification, but differed by shift with adequate hand hygiene less likely to be observed during the night shift (p = 0.03). The midwives’ hand hygiene practices were influenced by cognitive, psychological, environmental and contextual factors including habits, gloving norms, time, workload, inadequate knowledge and infection risk perception. Conclusion The resulting insights from formative research suggest a multi-component improvement intervention that addresses the different key behaviour determinants to be designed for the labour and delivery room. A combination of disruption of the physical environment via nudges and cues, participatory education to the midwives and the promotion of new norms using social influence and affiliation may increase the birth attendants’ hand hygiene compliance in our study settings.

scholarly journals Hand Hygiene During Facility-Based Childbirth in Cambodia: A Theory-Driven, Mixed-Methods Observational Study

2021 ◽  
Author(s):  
Yolisa Nalule ◽  
Helen Buxton ◽  
Por Ir ◽  
Supheap Leang ◽  
Alison Macintyre ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Night Shift ◽  
Formative Research ◽  
Health Care Facilities ◽  
Environmental Drivers ◽  
Birth Attendants ◽  
Hygiene Practices ◽  
Hygiene Compliance

Abstract Background Despite current efforts to improve hand hygiene in health care facilities, compliance among birth attendants remains low. Current improvement strategies are inadequate, largely focusing on a limited set of known behavioural determinants or addressing hand hygiene as part of a generalized set of hygiene behaviours. To inform the design of a facility –based hand hygiene behaviour change intervention in Kampong Chhnang, Cambodia, a theory-driven formative research study was conducted to investigate the context specific behaviours and determinants of handwashing during labour and delivery among birth attendants. Methods This formative mixed-methods research followed a sequential explanatory design and was conducted across eight healthcare facilities. The hand hygiene practices of all birth attendants present during the labour and delivery of 45 women were directly observed and compliance with hand hygiene protocols assessed in analysis. Semi-structured, interactive interviews were subsequently conducted with 20 key healthcare workers to explore the corresponding cognitive, emotional, and environmental drivers of hand hygiene behaviours. Results Birth attendants’ compliance with hand hygiene protocol was 18% prior to performing labour, delivery and newborn aftercare procedures. Hand hygiene compliance did not differ by facility type or attendants’ qualification, but differed by shift with adequate hand hygiene less likely to be observed during the night shift (p = 0.03). The midwives’ hand hygiene practices were influenced by cognitive, psychological, environmental and contextual factors including habits, gloving norms, time, workload, inadequate knowledge and infection risk perception. Conclusion The resulting insights from formative research suggest a multi-component improvement intervention that addresses the different key behaviour determinants to be designed for the labour and delivery room. A combination of disruption of the physical environment via nudges and cues, participatory education to the midwives and the promotion of new norms using social influence and affiliation may increase the birth attendants’ hand hygiene compliance in our study settings.

scholarly journals Production of Disinfectants (Hand Sanitizers)

2021 ◽  
pp. 152-156
Author(s):  
Srushti Alesa
Keyword(s):  
Medicinal Plants ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Ethanolic Extract ◽  
Hand Washing ◽  
Absolute Ethanol ◽  
Hand Sanitizer ◽  
Ethanolic Extraction ◽  
Hygiene Compliance ◽  
Locally Grown

Hand sanitizer is a supplement or alternative to hand washing with soap and water. The production of hand sanitizers from locally grown medicinal plants namely; wild spinach, turmeric, garlic) and camphor was achieved by obtaining the plants, grinding and performing ethanolic extraction for 72hrs on them. This ethanolic extract in combination with glycerin and absolute ethanol were used for the final preparation. Turmeric and garlic failed the hand sanitizer ‘s approval test based on their colour and pungent smell, but wild spinach and camphor were found to be good candidates for hand sanitizers production here in Nigeria and inclusion of such products here could increase hand hygiene compliance levels.

scholarly journals Do wearable alcohol-based handrub dispensers increase hand hygiene compliance? - a mixed-methods study

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Jonas Keller ◽  
Aline Wolfensberger ◽  
Lauren Clack ◽  
Stefan P. Kuster ◽  
Mesida Dunic ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Mixed Methods Study ◽  
Hygiene Compliance
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