scholarly journals Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

2017 ◽  
Vol 22 (23) ◽  
Author(s):  
Maria Luisa Moro ◽  
Filomena Morsillo ◽  
Simona Nascetti ◽  
Mita Parenti ◽  
Benedetta Allegranzi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Absolute Increase ◽  
Italian Regions ◽  
Hygiene Promotion ◽  
Before And After ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Implementation Progress

A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.

scholarly journals Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity

2018 ◽  
Vol 19 (3) ◽  
pp. 116-122 ◽  
Author(s):  
A Jeanes ◽  
J Dick ◽  
P Coen ◽  
N Drey ◽  
DJ Gould
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Care Delivery ◽  
Compliance Rate ◽  
Significant Risk ◽  
World Health ◽  
Compliance Monitoring ◽  
Infection Control Practitioner ◽  
Hygiene Compliance ◽  
Health Organization

Background: Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low. Aims: To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance. Methods: The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool. Findings: In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk. Discussion: We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty.

scholarly journals Appropriate Number of Observations For Determining Hand Hygiene Compliance Among Healthcare Workers

2021 ◽  
Author(s):  
Se Yoon Park ◽  
Suyeon Park ◽  
Eunjung Lee ◽  
Tae Hyong Kim ◽  
Sungho Won
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
Hygiene Compliance ◽  
Health Organization

Abstract We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (CI) (1-α) [The equation: n ≥ Z2 α/2 * p * (1-p)/d2 ]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8,791 HH opportunities among 1,168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 (d: 30%, CI: 90%) to 624 (d: 5%, CI: 99%), and that for optimal HH compliance ranged from 5 (d: 30%, CI: 90%) to 642 (d: 5%, CI: 99%). We found that at least five observations were needed to determine optimal HH compliance with 30% absolute precision and a 90% CI.

scholarly journals Appropriate Number of Observations to Determine Hand Hygiene Compliance Among Healthcare Workers

2021 ◽  
Vol 1 (S1) ◽  
pp. s64-s64
Author(s):  
Se Yoon Park ◽  
Eunjung Lee ◽  
Suyeon Park ◽  
Tae Hyong Kim ◽  
Sungho Won
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
The Mean ◽  
Hygiene Compliance ◽  
Health Organization

Background: We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. Methods: The study was conducted at a referral hospital. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Appropriate HH compliance rates were calculated based on the 6-step technique, modified from the World Health Organization (WHO) recommendation. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (1-α) [The equation: n3 Zα/22×ρ×1-ρ/d2]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%, respectively. Among the various cases, we focused on 10% for d and 95% for CI. Results: During the study period, 8,791 opportunities among 1,168 healthcare workers were monitored. The mean HH compliance and appropriate HH compliance rates were 80.3% and 59.7%, respectively (Table 1). The minimum number of observations required to determine HH compliance rates ranged from 2 (d, 30%; CI, 90%) to 624 (d, 5%; CI, 99%), and the minimum number of observations for optimal HH compliance ranged from 5 (d, 30%, CI, 90%) to 642 (d, 5%; CI, 99%) (Figure 1). At 10% absolute precision with 95% confidence, the minimum number of observations to determine HH and optimal HH compliance were 61 and 92, respectively. Conclusions: The minimum number of observations to determine HH compliance varies widely according to setting, but at least 5 were needed to determine optimal HH compliance.Funding: NoDisclosures: None

scholarly journals Hand hygiene compliance in Dutch general practice offices: an observational study.

2020 ◽  
Author(s):  
Nataliya Hilt ◽  
Mariëtte Lokate ◽  
Alfons OldeLoohuis ◽  
Marlies EJL Hulscher ◽  
Alex W Friedrich ◽  
...  
Keyword(s):  
Observational Study ◽  
Hand Hygiene ◽  
General Practitioners ◽  
Hand Hygiene Compliance ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
World Health ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Abstract Background Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline.Methods An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional.Results We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34%, 51% and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR).Conclusions HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.

scholarly journals Hand hygiene compliance in Dutch general practice offices

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Nataliya Hilt ◽  
Mariëtte Lokate ◽  
Alfons OldeLoohuis ◽  
Marlies E. J. L. Hulscher ◽  
Alex W. Friedrich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
General Practitioners ◽  
Hand Hygiene Compliance ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
World Health ◽  
Hand Wash ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Abstract Background Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline. Methods An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional. Results We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34, 51 and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR). The median time of disinfecting hands was 8 s (range 6–11 s) for HCWs in our study. Conclusions HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.

scholarly journals Appropriate number of observations for determining hand hygiene compliance among healthcare workers

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Se Yoon Park ◽  
Suyeon Park ◽  
Beom Seuk Hwang ◽  
Eunjung Lee ◽  
Tae Hyong Kim ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
Hygiene Compliance ◽  
Health Organization

AbstractWe sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (ρ), absolute precision (d), and confidence interval (CI) (1 − α) [the equation: $${\text{n}} \ge Z_{\alpha /2}^{2} \times \rho \times \left( {1 - \rho } \right)/d^{2}$$ n ≥ Z α / 2 2 × ρ × 1 - ρ / d 2 ]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8791 HH opportunities among 1168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 ($$d$$ d : 30%, CI: 90%) to 624 ($$d$$ d : 5%, CI: 99%), and that for optimal HH compliance ranged from 5 ($$d$$ d : 30%, CI: 90%) to 642 ($$d$$ d : 5%, CI: 99%). Therefore, we found that our hospital required at least five observations to determine optimal HH compliance.

scholarly journals “The Dirty Hand in the Latex Glove”: A Study of Hand Hygiene Compliance When Gloves Are Worn

2011 ◽  
Vol 32 (12) ◽  
pp. 1194-1199 ◽  
Author(s):  
Christopher Fuller ◽  
Joanne Savage ◽  
Sarah Besser ◽  
Andrew Hayward ◽  
Barry Cookson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
The Elderly ◽  
World Health ◽  
Risk Level ◽  
Latex Glove ◽  
Type Contact ◽  
Hygiene Compliance ◽  
Health Organization

Background and Objective.Wearing of gloves reduces transmission of organisms by healthcare workers' hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used nonstandardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn.Design.Observational study.Participants and Setting.Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales.Methods.We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts.Results.Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]; P<.0001).Conclusion.The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene.Trial Registration.National Research Register N0256159318.

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

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