TRANSLATING HAND HYGIENE PRACTICE INTO COMPLIANCE DURING ASEPTIC WOUND DRESSING

INTRODUCTION: Over the past decade, we have witnessed some amazing innovations in the field of aseptic wound dressing. However, hygiene compliance during this common procedure still remains poorly observed. BACKGROUND: In the late 1800s, Florence Nightingale, revolutionised the practice by implementing the principle of hand washing and other hygienic practice during the Crimean War. Growing burden of healthcare-associated infection have yielded enough scientific evidence to support the claim that hand hygiene alone is capable of substantially reducing the risk of cross-transmission. AIMS: This study explores factors associated with hand hygiene compliance during aseptic wound dressing among healthcare workers. METHOD: This is a cross-sectional survey conducted among various public healthcare workers in the state of Johor (Malaysia). Descriptive and inferential statistics were computed to analyse the data. RESULT: A total of 451 HCWs have volunteer and out of which majority work as a Registered Nurse (n=262, 58%), compared to other health worker (n=189, 42%). Almost all of HCW (n=446, 99%) feel wound dressing took long time to finish regardless of experience. DISCUSSION: We found that using the standardised forms as the assisting method significantly improved hand hygiene compliance during aseptic wound dressing regardless of working experience. CONCLUSION: Although nurses are predominantly responsible for handling wound care, but various factors are almost similar which can improve adherence to hand hygiene standards, and experience can be gained along the way.

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NICU Healthcare Workers Hand Hygiene Compliance during 6 Months of Direct Observation

JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga ◽

10.20473/juxta.v11i12020.41-44 ◽

2020 ◽

Vol 11 (1) ◽

pp. 41

Author(s):

Inna Fairuuza Firdaus ◽

Dwiyanti Puspitasari ◽

Marijam Purwanta

Keyword(s):

Hand Hygiene ◽

General Hospital ◽

Direct Observation ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Patient Contact ◽

Healthcare Associated Infection ◽

Effective Measure ◽

Hygiene Compliance ◽

Healthcare Associated

Introduction: Hospitalized neonates are at risk of developing nosocomial sepsis, a systemic infection due to unhygienic healthcare, especially in Indonesia where healthcare-associated infection incidence rate is 5.9%-8.3%. Hand hygiene by healthcare workers is an effective measure to prevent it. This study aimed to understand the healthcare workers’ hand hygiene compliance towards WHO guidelines 2009 in Dr. Soetomo General Hospital NICU. Methods: This research was an observational study. The healthcare workers’ hand hygiene compliance was obtained through 6 months of direct observation, from November 2018 to April 2019, with doctors and nurses who agreed to be observed and present during the observation period as samples. The observation was recorded with WHO observation form, and processed with Microsoft Excel 2013 to obtain compliance rate. Results: Overall, the compliance of healthcare worker in NICU Dr. Soetomo General Hospital during the 6 months of study was 84%. Nurses’ compliance was higher (87%) than doctors’ (78%). Compliance to My 5 Moments of Hand Hygiene indications varied from 82% for moments before patient contact to 93% for moments after patient contact. Conclusion: In conclusion, hand hygiene compliance of healthcare workers in Dr. Soetomo General Hospital NICU varied between profession categories and each indication. To maintain and improve hand hygiene compliance, intervention in healthcare workers’ behavior is needed, so that healthcare-associated infection can be better prevented.

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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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Impact of sink location on hand hygiene compliance after care of patients with Clostridium difficile infection: a cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-016-1535-x ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 20

Author(s):

Alexander Deyneko ◽

Fernanda Cordeiro ◽

Laurie Berlin ◽

Debby Ben-David ◽

Silvana Perna ◽

...

Keyword(s):

Clostridium Difficile ◽

Hand Hygiene ◽

Clostridium Difficile Infection ◽

Hand Hygiene Compliance ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

After Care ◽

Hygiene Compliance ◽

Sink Location

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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1130 ◽

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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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 healthcare workers in a superspeciality tertiary care hospital

Journal of Patient Safety & Infection Control ◽

10.4103/jpsic.jpsic_4_19 ◽

2019 ◽

Vol 7 (1) ◽

pp. 5

Author(s):

Neeta Patwardhan ◽

Satish Patwardhan

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Hygiene Compliance

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Assessment of correlates of hand hygiene compliance among final year medical students: a cross-sectional study in the Netherlands

BMJ Open ◽

10.1136/bmjopen-2019-029484 ◽

2020 ◽

Vol 10 (2) ◽

pp. e029484

Author(s):

Vicki Erasmus ◽

Suzie Otto ◽

Emmely De Roos ◽

Rianne van Eijsden ◽

Margreet C Vos ◽

...

Keyword(s):

Risk Perception ◽

Medical Students ◽

The Netherlands ◽

Hand Hygiene ◽

Self Efficacy ◽

Hand Hygiene Compliance ◽

Secondary Outcome ◽

Factual Knowledge ◽

Cross Sectional ◽

Hygiene Compliance

ObjectivesTo identify the factors that influence the hand hygiene compliance of final year medical students, using a theoretical behavioural framework.DesignCross-sectional survey assessing self-reported compliance and its behavioural correlates.SettingInternships of medical students in the Netherlands.Participants322 medical students of the Erasmus Medical Center were recruited over a period of 12 months during the Public Health internship, which is the final compulsory internship after an 18-month rotation schedule in all major specialities.Primary and secondary outcome measuresBehavioural factors influencing compliance to hand hygiene guidelines were measured by means of a questionnaire based on the Theory of Planned Behaviour and Social Ecological Models. Multiple linear regression analysis was used to identify the effect of including attitudes, social norms, self-efficacy, knowledge, risk perception and habit on hand hygiene compliance.ResultsWe included 313 students in the analysis (response rate 97%). The behavioural model explained 40% of the variance in self-reported compliance (adjusted R2=0.40). Hand hygiene compliance was strongly influenced by attitudes (perceived outcomes of preventive actions), self-efficacy (perception of the ability to perform hand hygiene at the clinical ward) and habit, but was not associated with knowledge and risk perception.ConclusionsTargeting medical students’ behaviour should focus on the empowerment of these juniors and provide them with evidence on the health benefits of prevention, rather than increasing their factual knowledge of procedures. Clinical teaching environments could help them form good patient safety habits during this vital phase of their career.

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Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study

Journal of Patient Safety and Risk Management ◽

10.1177/2516043520958579 ◽

2020 ◽

Vol 25 (5) ◽

pp. 177-186

Author(s):

Aaron Asibi Abuosi ◽

Samuel Kaba Akoriyea ◽

Gloria Ntow-Kummi ◽

Joseph Akanuwe ◽

Patience Aseweh Abor ◽

...

Keyword(s):

Health Care ◽

Observational Study ◽

Hand Hygiene ◽

Outcome Measures ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Hand Washing ◽

Job Aids ◽

The Mean ◽

Hygiene Compliance

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.

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