scholarly journals Barriers and Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals

2021 ◽  
Vol 18 (16) ◽  
pp. 8588
Author(s):  
Lucy K. Tantum ◽  
John R. Gilstad ◽  
Fatorma K. Bolay ◽  
Lily M. Horng ◽  
Alpha D. Simpson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Ebola Virus ◽  
Virus Disease ◽  
Low Cost ◽  
Hospital Staff ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Running Water ◽  
Hand Sanitizer ◽  
Hospital Infection Control

Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement.

scholarly journals Improving Hand Hygiene:Anonymously Validated Data Driven Approach Producing Sustainable Culture Change Utilizing “One and Up” Accountability Agents across a Healthcare System- a Cost-effective National Best Practice.

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S409-S409
Author(s):  
Jack Ross
Keyword(s):  
Hand Hygiene ◽  
Healthcare System ◽  
Cultural Change ◽  
Medical Staff ◽  
Best Practice ◽  
Low Cost ◽  
Performance Model ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Job Roles

Abstract Background Inadequate hand hygiene is a major contributor to hospital infections worldwide. Before 2012, in our healthcare system, hand hygiene was monitored by unit managers, nurses, and infection control staff with reported compliance rates of >90%. A five month independent audit by an anonymous observer revealed actual rates of 14–33%. This discordant result was typical of hospitals across the country then and now who have provided intensive education, used peer feedback, and maximized physical hand hygiene supplies. A commitment was made to rigorously improve hand hygiene utilizing validated data, social psychology with disciplinary consequence, and no additional expensive technology. Methods Employed dedicated “secret shopper”/anonymous observers were deployed across five hospitals, all units and all shifts, and all job roles to collect valid anonymous hand hygiene observations without local bias. Twice monthly hand hygiene data was shared by hospital, unit, shift, and job role to executive leadership and down to frontline unit staff for daily huddles. Additionally, over 100 “One and Up” Accountability Agents from management ranks were recruited, trained, and performed weekly standardized unit- based hand hygiene obervations openly, giving feedback real-time to non-compliant employess and medical staff; noncompliance was reported to the hospital epidemiologist; and emails on his behalf were sent to the employee’s manager, and the manager’s manager “One and Up”. A four step disciplinary process was begun. The same process was applied to the medical staff. Results Over 188, 000 anonymous secret shopper validation observations, and hundreds of thousands of Accountability Agent observations have been performed. Hand hygiene compliance has been >94% for 22 months and ≥97 % for the last 6 months in all five hospitals. No employee or medical staff member advanced beyond the second disciplinary step. Conclusion This model represents a national best performance model, with validated and sustained results, accomplished with cultural change and aligned multitier accountability (not technology). It is truly a low cost blueprint for other healthcare systems that seek rapid, honest, and sustained hand hygiene improvement across all job roles, shifts, and different sized hospitals and cultures. Disclosures All authors: No reported disclosures.

Measuring Healthcare Worker Hand Hygiene Activity: Current Practices and Emerging Technologies

2011 ◽  
Vol 32 (10) ◽  
pp. 1016-1028 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Electronic Monitoring ◽  
Monitoring Systems ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Gold Standard Method ◽  
Improvement Programs ◽  
Hygiene Compliance

Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of multidisciplinary hand hygiene improvement programs. Observational surveys conducted by trained personnel are currently considered the “gold standard” method for establishing compliance rates, but they are time-consuming and have a number of shortcomings. Monitoring hand hygiene product consumption is less time-consuming and can provide useful information regarding the frequency of hand hygiene that can be used to give caregivers feedback. Electronic counting devices placed in hand hygiene product dispensers provide detailed information about hand hygiene frequency over time, by unit and during interventions. Electronic hand hygiene monitoring systems that utilize wireless systems to monitor room entry and exit of healthcare workers and their use of hand hygiene product dispensers can provide individual and unit-based data on compliance with the most common hand hygiene indications. Some systems include badges (tags) that can provide healthcare workers with real-time reminders to clean their hands upon entering and exiting patient rooms. Preliminary studies suggest that use of electronic monitoring systems is associated with increased hand hygiene compliance rates and that such systems may be acceptable to care givers. Although there are many questions remaining about the practicality, accuracy, cost, and long-term impact of electronic monitoring systems on compliance rates, they appear to have considerable promise for improving our efforts to monitor and improve hand hygiene practices among healthcare workers.

scholarly journals Safe Hands: teaching innovation project to improve hand hygiene in health sciences.

2015 ◽  
Author(s):  
Jacobo Cambil-Martin
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Health Sciences ◽  
World Health ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Teaching Innovation ◽  
Multimodal Strategy ◽  
The World ◽  
Innovation Project

Background: Since 2004, the World Alliance for Patient Safety brings proposing hand hygiene as the key measure of its international strategy in the fight against healthcare-associated infections. In Spain the Safe Hands Distinction of the Patient Safety Observatory recognizes the good practices on improving hand hygiene of the World Health Organization. Objectives: Apply the WHO multimodal strategy to improve hand hygiene at the Faculty of Health Sciences and maintain the culture of Patient Safety on hand hygiene by students and staff. Methods: A teaching innovation project called "Safe Hands" was developed in the Nursing Degree at the Faculty of Health Sciences of the University of Granada during the academic period 2013-2015. The tool "Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy" served to develop and plan the program to improve hand hygiene according to its five phases. In parallel, activities were implemented according to the three stages of the accreditation process "Safe Hands Distinction". Results: The Faculty of Health Sciences has become a dynamic secure environment that provides alcoholic gel for practice and training on hand hygiene, disseminates information and updated signage, reinforces the training of students and staff, and reinforces the quality assurance project. Study Limitations: It is necessary to complete the five years cycle of continuous improvement in quality of the WHO guide to establish an optimal strategy for improving hand hygiene. Conclusion: Safe Hands has launched the WHO multimodal strategy in an academic context. The Faculty of Health Sciences has got credited the Safe Hands Distinction, becoming the first Higher Education Center accredited in Spain to improve hand hygiene.

scholarly journals Assessment of Self-Contamination During Removal of Personal Protective Equipment for Ebola Patient Care

2016 ◽  
Vol 37 (10) ◽  
pp. 1156-1161 ◽  
Author(s):  
Lisa M. Casanova ◽  
Lisa J. Teal ◽  
Emily E. Sickbert-Bennett ◽  
Deverick J. Anderson ◽  
Daniel J. Sexton ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Ebola Virus ◽  
Virus Disease ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Dominant Hand ◽  
Enveloped Virus ◽  
Standardized Protocol

OBJECTIVEEbola virus disease (EVD) places healthcare personnel (HCP) at high risk for infection during patient care, and personal protective equipment (PPE) is critical. Protocols for EVD PPE doffing have not been validated for prevention of viral self-contamination. Using surrogate viruses (non-enveloped MS2 and enveloped Φ6), we assessed self-contamination of skin and clothes when trained HCP doffed EVD PPE using a standardized protocol.METHODSA total of 15 HCP donned EVD PPE for this study. Virus was applied to PPE, and a trained monitor guided them through the doffing protocol. Of the 15 participants, 10 used alcohol-based hand rub (ABHR) for glove and hand hygiene and 5 used hypochlorite for glove hygiene and ABHR for hand hygiene. Inner gloves, hands, face, and scrubs were sampled after doffing.RESULTSAfter doffing, MS2 virus was detected on the inner glove worn on the dominant hand for 8 of 15 participants, on the non-dominant inner glove for 6 of 15 participants, and on scrubs for 2 of 15 participants. All MS2 on inner gloves was observed when ABHR was used for glove hygiene; none was observed when hypochlorite was used. When using hypochlorite for glove hygiene, 1 participant had MS2 on hands, and 1 had MS2 on scrubs.CONCLUSIONSA structured doffing protocol using a trained monitor and ABHR protects against enveloped virus self-contamination. Non-enveloped virus (MS2) contamination was detected on inner gloves, possibly due to higher resistance to ABHR. Doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents.Infect Control Hosp Epidemiol 2016;1–6

scholarly journals Multi-Facility Reduction in Hospital-Acquired Infections (HAIs) Through Real-Time Feedback and Individual Accountability

2020 ◽  
Vol 41 (S1) ◽  
pp. s323-s324
Author(s):  
Christopher Hermann ◽  
Metta Watters ◽  
Rebecca Sharrer ◽  
Randy Ennis
Keyword(s):  
Hand Hygiene ◽  
Real Time ◽  
Baseline Period ◽  
Primary Study ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
The Impact ◽  
The Voice

Background: Hospital-acquired infections (HAIs) are a leading cause of healthcare morbidity and cost for the health community. It is widely recognized that hand hygiene is the leading contributor infections, but hand hygiene still remains a major problem for nearly all healthcare systems. A longitudinal study was conducted over a 4-year period in a community-based health system. Methods: An electronic hand hygiene reminder system was installed in 2 different facilities including both critical care and noncritical units. This system collects data on individual healthcare provider hand hygiene and provides a real-time voice reminder in the event that a provider forgets to perform hand hygiene. The primary study was designed to investigate the impact of a real-time voice reminder to improve hand hygiene. A baseline period of hand hygiene was established prior to the interventions after installing the system without any access to data reporting or the voice reminder. Each of the hospitals had the voice reminder turned on and off 3 times. The baseline HAI rates were established by comparing in each facility for the 12 months prior to the implementation of the system. During the study period, there were no significant changes to other common infection control practices. Results: In both facilities, every time the voices were turned on, hand hygiene improved significantly and each clinical unit saw a >200% improvement in hand hygiene within 3 months of turning the voice reminder. HAIs fell by a statistically significant in all clinical areas by 51%. After a period of stabilization, the voice reminder was turned off hand hygiene compliance fell and HAI rates then increased. The voice reminder was then turned back on and off 2 more times. In every case, hand hygiene rates fell back to the baseline and HAIs returned to their baseline. When the voice reminder was then turned back on, HAIs dropped to 54%–81% of the baseline in each of the clinical units. The system also captured individual providers’ hand hygiene performance data and displayed it in a simple and engaging way, allowing managers easily understand who was struggling with hand hygiene. These data were then leveraged through a series of competitions to systematically drive hand hygiene performance improvement. These included traditional interventions to address an education issue in addition to interventions to identify workflow problems. Conclusions: Using this highly targeted approach, the leadership were able to efficiently drive sustained hand hygiene improvement and a further reduction in HAIs.Funding: NoneDisclosures: None

scholarly journals Checklist of African Soapy Saponin—Rich Plants for Possible Use in Communities’ Response to Global Pandemics

Plants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 842
Author(s):  
Yvonne Kunatsa ◽  
David R. Katerere
Keyword(s):  
Hand Hygiene ◽  
Review Paper ◽  
Foaming Properties ◽  
Review Of Literature ◽  
Improve Hand Hygiene ◽  
Natural Form ◽  
Running Water ◽  
Home Based ◽  
Commercial Soap ◽  
Potential Use

Plants that exhibit foaming properties when agitated in aqueous solutions are commonly referred to as soapy plants, and they are used in different communities for washing, bathing, and hair shampooing. The frothing ability of these plants is attributed to saponins which are also well-documented to possess antimicrobial attributes. In the light of COVID-19, soap and hand hygiene have taken center stage. The pandemic has also revealed the low access to running water and commercial soaps in many marginalized and poor communities to the detriment of global health. Thus, soapy plants, either in their natural form or through incorporation in commercial products, may be a relevant additional weapon to assist communities to improve hand hygiene and contribute to curbing COVID-19 and other communicable infections. This review paper was compiled from a review of literature that was published between 1980 and 2020. We found 68 plant species, including those which are already used as traditional soaps. Our findings support the potential use of extracts from soapy plants because of their putative viricidal, bactericidal, and fungicidal activities for use in crude home-based formulations and possibly for developing natural commercial soap products.

scholarly journals Infection Control Knowledge, Attitudes, and Practices among Healthcare Workers in Addis Ababa, Ethiopia

2013 ◽  
Vol 34 (12) ◽  
pp. 1289-1296 ◽  
Author(s):  
Admasu Tenna ◽  
Edward A. Stenehjem ◽  
Lindsay Margoles ◽  
Ermias Kacha ◽  
Henry M. Blumberg ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Addis Ababa ◽  
World Health ◽  
Hand Sanitizer ◽  
Attitudes And Practices ◽  
Hospital Infection Control ◽  
Control Knowledge ◽  
Knowledge Attitudes And Practices ◽  
Tb Infection Control

Objective.To better understand hospital infection control practices in Ethiopia.Design.A cross-sectional evaluation of healthcare worker (HCW) knowledge, attitudes, and practices about hand hygiene and tuberculosis (TB) infection control measures.Methods.An anonymous 76-item questionnaire was administered to HCWs at 2 university hospitals in Addis Ababa, Ethiopia. Knowledge items were scored as correct/incorrect. Attitude and practice items were assessed using a Likert scale.Results.In total, 261 surveys were completed by physicians (51%) and nurses (49%). Fifty-one percent of respondents were male; mean age was 30 years. While hand hygiene knowledge was fair, self-reported practice was suboptimal. Physicians reported performing hand hygiene 7% and 48% before and after patient contact, respectively. Barriers for performing hand hygiene included lack of hand hygiene agents (77%), sinks (30%), and proper training (50%) as well as irritation and dryness (67%) caused by hand sanitizer made in accordance with the World Health Organization formulation. TB infection control knowledge was excellent (more than 90% correct). Most HCWs felt that they were at high risk for occupational acquisition of TB (71%) and that proper TB infection control can prevent nosocomial transmission (92%). Only 12% of HCWs regularly wore a mask when caring for TB patients. Only 8% of HCWs reported that masks were regularly available, and 76% cited a lack of infrastructure to isolate suspected/known TB patients.Conclusions.Training HCWs about the importance and proper practice of hand hygiene along with improving hand sanitizer options may improve patient safety. Additionally, enhanced infrastructure is needed to improve TB infection control practices and allay HCW concerns about acquiring TB in the hospital.

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