Faculty Opinions recommendation of Improving healthcare worker hand hygiene adherence before patient contact: a before-and-after five-unit multimodal intervention in Tuscany.

Author(s):  
Julie Storr
2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  

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


2015 ◽  
Vol 37 (3) ◽  
pp. 272-280 ◽  
Author(s):  
Camille Pelat ◽  
Lidia Kardaś-Słoma ◽  
Gabriel Birgand ◽  
Etienne Ruppé ◽  
Michaël Schwarzinger ◽  
...  

BACKGROUNDThe best strategy for controlling extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) transmission in intensive care units (ICUs) remains elusive.OBJECTIVEWe developed a stochastic transmission model to quantify the effectiveness of interventions aimed at reducing the spread of ESBL-PE in an ICU.METHODSWe modeled the evolution of an outbreak caused by the admission of a single carrier in a 10-bed ICU free of ESBL-PE. Using data obtained from recent muticenter studies, we studied 26 strategies combining different levels of the following 3 interventions: (1) increasing healthcare worker compliance with hand hygiene before and after contact with a patient; (2) cohorting; (3) reducing antibiotic prevalence at admission with or without reducing antibiotherapy duration.RESULTSImproving hand hygiene compliance from 55% before patient contact and 60% after patient contact to 80% before and 80% after patient contact reduced the nosocomial incidence rate of ESBL-PE colonization by 91% at 90 days. Adding cohorting to hand hygiene improvement intervention decreased the proportion of ESBL-PE acquisitions by an additional 7%. Antibiotic restriction had the lowest impact on the epidemic. When combined with other interventions, it only marginally improved effectiveness, despite strong hypotheses regarding antibiotic impact on transmission.CONCLUSIONOur results suggest that hand hygiene is the most effective intervention to control ESBL-PE transmission in an ICU.Infect. Control Hosp. Epidemiol. 2016;37(3):272–280


2019 ◽  
Vol 13 ◽  
Author(s):  
Maria Amanda Pereira Leite ◽  
Maria Alenita De Oliveira ◽  
Rafaella De Menezes Leuthier ◽  
Josélio Rodrigues Oliveira Filho ◽  
Larissa Gabriella Alves Fernandes ◽  
...  

RESUMOObjetivo: avaliar o conhecimento e a compreensão dos profissionais da saúde em relação à prática de higiene das mãos. Método: trata-se de estudo quantitativo, descritivo, transversal, com 56 profissionais de um hospital filantrópico. Utilizaram-se, para a coleta de dados, dois questionários. Inseriram-se os dados em um banco de dados no Programa Microsoft® Office Excel, analisando-os por meio de estatística descritiva. Apresentaram-se os resultados em forma de tabelas. Resultados: verificou-se que 100% dos profissionais consideram importante a higienização das mãos e reconhecem as mãos como agente indutor de infecção e que a prática da higiene leva à sua prevenção; 64% afirmaram que praticam uma perfeita higienização antes e após o contato com o paciente. Observou-se, entretanto, após a avaliação da taxa de adesão a oportunidades de higiene de mãos, baixa taxa de adesão de 8,5%. Conclusão: revela-se que, apesar de a equipe de profissionais ter uma percepção adequada da importância da higienização das mãos e de ter conhecimento sobre o tema, isso não se reflete no cotidiano. Descritores: Higiene das Mãos; Segurança do Paciente; Infecção Hospitalar; Hospital; Assistência à Saúde; Prevenção de Doenças; Recursos Humanos em Saúde.  ABSTRACT Objective: to evaluate the knowledge and understanding of health professionals in relation to the practice of hand hygiene. Method: this is a quantitative, descriptive, cross-sectional study, with 56 professionals from a philanthropic hospital. Data collection occurred by means of two questionnaires. The data were entered into a database in Microsoft® Office Excel, analyzing them by means of descriptive statistics. The results are presented as tables. Results: 100% of the professionals consider hand hygiene important and recognize the hands as inducing agent of infection and that the practice of hygiene leads to its prevention; 64% reported carrying out a perfect hygiene before and after patient contact. However, the evaluation of the rate of adherence to opportunities of hand hygiene was low, with the 8.5%. Conclusion: although the team of professionals has an adequate perception of the importance of hand washing and has knowledge about the topic, this is not reflected in the routine. Descriptors: Hand Hygiene; Patient Safety; Cross Infection; Hospital; Health Care; Disease Prevention; Health Human Resources.   RESUMEN Objetivo: evaluar el conocimiento y la comprensión de los profesionales de la salud en relación con la práctica de la higiene de las manos. Método: se trata de un estudio cuantitativo, descriptivo, transversal, con 56 profesionales de un hospital filantrópico. Se utilizaron para la recolección de datos dos cuestionarios. Los datos fueron introducidos en una base de datos de Microsoft® Office Excel, y analizados por medio de estadísticas descriptivas. Los resultados se presentan en forma de tablas. Resultados: se encontró que 100% de los profesionales consideran importante la higiene de las manos y reconocen las manos como agentes inductores de la infección y que la práctica de la higiene conduce a su prevención; 64% dijieron que hacen una práctica perfecta de higiene antes y después del contacto con el paciente. También se observó, sin embargo, después de la evaluación de la tasa de adhesión a las oportunidades de higiene de manos, la baja adhesión, con 8,5%. Conclusión: se revela que, a pesar de que el equipo de profesionales tiene una adecuada percepción de la importancia de lavarse las manos y tiene conocimientos sobre el tema, pero no lo hacen en su cotidiano. Descriptores: Higiene de las Manos; Seguridad del Paciente; Infección Hospitalaria; Hospitales; Atención de Salud; Prevención de Enfermedades; Recursos Humanos en Salud.


2021 ◽  
Vol 8 (11) ◽  
pp. 260
Author(s):  
Kira Schmitt ◽  
Anna Barbara Emilia Zimmermann ◽  
Roger Stephan ◽  
Barbara Willi

Hand hygiene (HH) is the most important measure to prevent nosocomial infections. HH compliance in companion animal clinics has been reported to be poor. The present study compared an online application with the WHO evaluation form to assess the WHO five moments of HH in a Swiss companion animal clinic. In 202 hand swabs from 87 staff members, total viable count (TVC) before and after patient contact was evaluated and the swabs were tested for selected antimicrobial resistant microorganisms of public health importance. HH compliance (95% confidence interval) was 36.6% (33.8–39.5%) and was similar when assessed with the two evaluation tools. HH differed between hospital areas (p = 0.0035) and HH indications (p < 0.0001). Gloves were worn in 22.0% (18.0–26.6%) of HH observations and were indicated in 37.2% (27.3–48.3%) of these observations. Mean TVC before patient contact was lower (0.52 log CFU/cm2) than after patient contact (1.02 log CFU/cm2) but was similar before patient contact on gloved and ungloved hands. Three hand swabs (1.5% (0.4–4.3%)) were positive for methicillin-resistant Staphylococcus aureus. Gloving should not be regarded as a substitute for HH. Overall, HH in companion animal medicine should urgently be fostered.


2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S400-S400
Author(s):  
Hitoshi Honda ◽  
Tomoko Sakihama ◽  
Sanjay Saint ◽  
Karen Fowler ◽  
Toru Kamiya ◽  
...  

2014 ◽  
Vol 35 (3) ◽  
pp. 313-316 ◽  
Author(s):  
Sarah R. Lieber ◽  
Elisabetta Mantengoli ◽  
Sanjay Saint ◽  
Karen E. Fowler ◽  
Carlo Fumagalli ◽  
...  

We assessed hand hygiene adherence in 2 infectious disease units. In one unit, adherence declined slightly from year 1 (84.2%) to year 4 (71.0%) after a multimodal intervention but remained much higher than before intervention. Adherence dropped in the second unit after a loss of leadership (from 50.7% to 5.7%). Strong leadership presence may improve hand hygiene adherence.


2020 ◽  
Vol 15 (2020-05) ◽  
pp. 262-267 ◽  
Author(s):  
Akihiko Saitoh ◽  
Kiyomi Sato ◽  
Yoko Magara ◽  
Kakuei Osaki ◽  
Kiyoko Narita ◽  
...  

OBJECTIVES: Our objectives were to evaluate hand hygiene adherence among physicians and nurses before touching hospitalized patients and to evaluate changes in hand hygiene adherence after a multimodal intervention was implemented. DESIGN, SETTING, AND PARTICIPANTS: We conducted a pre- and postintervention study with HCWs at four tertiary hospitals in Niigata, Japan. Hand hygiene observations were conducted from June to August 2018 (preintervention) and February to March 2019 (postintervention). INTERVENTION: The multimodal hand hygiene intervention recommended by the World Health Organization was tailored to each hospital and implemented from September 2018 to February 2019. MAIN OUTCOMES AND MEASURES: We observed hand hygiene adherence before touching patients in each hospital and compared rates before and after intervention. Intervention components were also evaluated. RESULTS: There were 2,018 patient observations preintervention and 1,630 postintervention. Overall, hand hygiene adherence improved from 453 of 2,018 preintervention observations (22.4%) to 548 of 1,630 postintervention observations (33.6%; P < .001). Rates improved more among nurses (13.9 percentage points) than among doctors (5.7 percentage points). Improvement varied among the hospitals: Hospital B (18.4 percentage points) was highest, followed by Hospitals D (11.4 percentage points), C (11.3 percentage points), and Hospital A (6.5 percentage points). CONCLUSIONS: A multimodal intervention improved hand hygiene adherence rates in physicians and nurses in Niigata, Japan; however, further improvement is necessary. Given the current suboptimal hand hygiene adherence rates in Japanese hospitals, the spread of COVID-19 within the hospital setting is a concern.


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