scholarly journals The evaluation of a multimodal hand hygiene improvement strategy in Cambodian hospitals

2020 ◽  
Vol 14 (09) ◽  
pp. 1047-1053
Author(s):  
Bomi An ◽  
Sook Ja Yang
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Large City ◽  
Healthcare Associated Infections ◽  
Assessment Framework ◽  
Improvement Strategy ◽  
Self Assessment ◽  
Hand Hygiene Improvement ◽  
Hygiene Compliance ◽  
Healthcare Associated

Introduction: Hand hygiene is the most effective method of preventing healthcare-associated infections. Healthcare-associated infections are considered serious in developing countries, and there are few reports on the hand-hygiene status of these countries. Thus, we evaluated hand-hygiene status in eight hospitals in Cambodia to understand and identify factors hindering effective infection control. Methodology: Eight infection-management instructors working in one of the eight Cambodian government hospitals in a large city were interviewed with the WHO Hand Hygiene Self-Assessment Framework. Results: The mean Hand Hygiene Self-Assessment Framework score across the eight hospitals was 177.81 ± 56.73. The overall level of compliance with the multimodal hand hygiene improvement strategy across these eight hospitals was basic-two hospitals scored inadequate and six hospitals scored basic. The scores for the 5 factors of the Hand Hygiene Self-Assessment Framework were as follows: 45.63 ± 15.45 for system change, 33.13 ± 16.89 for education and training, 27.81 ± 21.65 for evaluation and feedback, 58.13 ± 5.30 for reminders in the workplace, and 13.13 ± 11.00 for institutional safety climate for hand hygiene Conclusions: The promotion of hand hygiene compliance requires the establishment of a basic infrastructure, reinforcement of the hand hygiene education system, and provision of diverse educational materials, as well as the fostering of a professional workforce for education. Hospitals should also bolster their management systems for hand hygiene compliance.

scholarly journals Compliance with Hand Hygiene Among Healthcare Workers in Preventing Healthcare Associated Infections

2021 ◽  
Vol 7 (1) ◽  
pp. 57-69
Author(s):  
Ema Buković ◽  
Damir Važanić ◽  
Adriano Friganović ◽  
Vesna Svirčević ◽  
Cecilija Rotim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Healthcare Associated Infections ◽  
Review Of Literature ◽  
Hand Hygiene Improvement ◽  
Hygiene Compliance ◽  
Healthcare Associated

Introduction: Healthcare associated infections (HCAIs) represent a major public health issue. In Europe, 37 000 patients are affected annually by some sort of HCAI. HCAIs are preventable, and hand hygiene is an important measure in their prevention. During daily clinical practice, hands of healthcare workers (HCWs) are exposed to surfaces, various substances and objects; therefore, proper hand hygiene is the first step in preventing microorganism transmission. Aim: To determine the HCWs hand hygiene compliance with the guidelines of the World Health Organization through a systematic review of literature. Methods: A systematic review of literature based on the PRISMA statement guidelines using the PubMed database in a search for articles that evaluate the hand hygiene compliance among HCWs. Results: Six articles were taken into consideration by the availability of full-text articles and years of publication between 2010 and 2020. Results showed that compliance rate was the highest in studies that implemented World Health Organisation’s Multimodal Hand Hygiene Improvement Strategy or its modifications. Conclusion: The multimodal approach, as World Health Organisation’s multimodal strategy or its local modifications, has been shown as the best approach addressing the problem of hand hygiene compliance. Further areas for research include finding a better method of measuring compliance, technology-driven solutions for both delivery of alcohol-based handrub and monitoring of its use, a greater focus on evaluating proper hand hygiene techniques, and insuring longer-term programs of training and education to achieve the best effectiveness of hand hygiene compliance among HCWs.

scholarly journals Hand hygiene adherence among Iranian nurses: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Bijan Nouri ◽  
Mohammad Hajizadeh ◽  
Kaveh Bahmanpour ◽  
Mahsa Sadafi ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Meta Analysis ◽  
Scientific Information ◽  
Systematic Search ◽  
Measurement Unit ◽  
Healthcare Associated Infections ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Nursing Managers ◽  
Healthcare Associated

Background & Aim: Adherence of nurses to hand hygiene is important for the prevention of healthcare-associated infections. This study aims to systematically review the existing studies that assess Iranian nurses' adherence to hand hygiene and estimate their amount with meta-analysis. Methods & Materials: We performed a systematic search for peer-reviewed journals published from 2005 to 2018. The systematic search was conducted using both international (Google Scholar, PubMed, SCOPUS, and Web of Sciences) and Iranian databases (Scientific Information Database, IranMedex, Magiran, and MedLib). The search was carried out using a combination of the following terms: “adherence”, “compliance”, “hand hygiene”, “nurse”, “Iran”, “nursing practice”, “nursing”, and “guidelines”. The combinations of these words with Boolean operators like ‘AND’, ‘OR’ and ‘NOT’ were used. Results:  A total of 22 articles were used in the final analyses. The pooled proportion of hand hygiene adherence was 40.5 percent [95% confidence interval [CI]: 31.1–49.8]. Sensitivity analysis confirmed that the overall estimated pooled proportion of hand hygiene adherence did not vary significantly with the elimination of any of the 22 studies, observer or self-reported hand hygiene, instrument of measurement, unit of measurements, sample size, and time. Conclusion: The level of adherence of Iranian nurses to hand hygiene can potentially increase the chance of healthcare-associated infections and put patients and nurses at risk. Hospital and nursing managers should take practical steps to investigate factors contributing to the failure of hand hygiene adherence among nursing staff. They should ensure the continuous implementation of hand hygiene improvement strategy.

scholarly journals Reduction in Intraoperative Bacterial Contamination of Peripheral Intravenous Tubing Through the Use of a Novel Device

2009 ◽  
Vol 110 (5) ◽  
pp. 978-985 ◽  
Author(s):  
Matthew D. Koff ◽  
Randy W. Loftus ◽  
Corey C. Burchman ◽  
Joseph D. Schwartzman ◽  
Megan E. Read ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Odds Ratio ◽  
Hand Hygiene Compliance ◽  
Group Versus ◽  
Control Group ◽  
Healthcare Associated Infections ◽  
Intravenous Tubing ◽  
Hygiene Compliance ◽  
Healthcare Associated

Background Hand hygiene is a vital intervention to reduce health-care associated infections, but compliance remains low. The authors hypothesized that improvements in intraoperative hand hygiene compliance would reduce transmission of bacteria to surgical patients and reduce the incidence of postsurgical healthcare-associated infections. Methods The authors performed a controlled before-and-after study over 2 consecutive months. One hundred fourteen operative cases were enrolled. Two predesignated sites on the anesthesia machine were selected, decontaminated, and cultured via aseptic technique. These sites and the peripheral intravenous stopcock were cultured again after completion of the surgery. The treatment phase used a novel personal hand-decontamination device capable of recording hand-decontamination events. Results There were no significant differences in patient location, age, or case duration and procedure type between groups. Use of the Sprixx GJ device (Harbor Medical Inc., Santa Barbara, CA) increased hourly hand decontamination events by 27-fold as compared with baseline rates (P < 0.002; 95% confidence interval, 3.3-13.4). Use of the device was associated with a reduction in contamination in the anesthesia work area and peripheral intravenous tubing. Intravenous tubing contamination was identified in 32.8% of cases in the control group versus 7.5% in the treatment group (odds ratio, 0.17; 95% confidence interval, 0.06-0.51; P < 0.01). Healthcare-associated infections rates were reduced in the device group (3.8%) as compared with the control group (17.2%) (odds ratio, 0.19; 95% confidence interval, 0.00-0.81; P = 0.02). Conclusions Improved hand hygiene compliance through the use of a novel hand sanitation strategy reduces the risk of intraoperative bacterial transmission. The intervention was associated with a reduction in healthcare-associated infections.

Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System

2016 ◽  
Vol 37 (8) ◽  
pp. 888-895 ◽  
Author(s):  
Matthew D. Koff ◽  
Jeremiah R. Brown ◽  
Emily J. Marshall ◽  
A. James O’Malley ◽  
Jens T. Jensen ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Operating Room ◽  
Performance Feedback ◽  
Group Performance ◽  
Medical Center ◽  
Fold Increase ◽  
Healthcare Associated Infections ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Healthcare Associated

BACKGROUNDHealthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development.OBJECTIVETo explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events.DESIGNRandomized, prospective study.SETTINGDartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts.PATIENTSPatients undergoing surgery.METHODSOperating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections.RESULTSA total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82–1.40], P=.626).CONCLUSIONSThe hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy.Infect Control Hosp Epidemiol 2016;37:888–895

scholarly journals Hand hygiene: are WHO Framework scores consistent with hand rub consumption data? A regional study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Garlasco ◽  
C Vicentini ◽  
I N Emelurumonye ◽  
F Quattrocolo ◽  
G D'Alessandro ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Performance Indicator ◽  
Statistical Significance ◽  
Good Practice ◽  
Local Health ◽  
Assessment Framework ◽  
Self Assessment ◽  
Hospital Unit ◽  
Hygiene Compliance

Abstract Background Hand hygiene represents one of the most effective measures to prevent infection transmission in healthcare facilities and may reduce healthcare-associated infections by up to 15-30%. In Piedmont (a region in North-West Italy), hand hygiene compliance is routinely monitored through the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and each hospital is also required to provide data about alcohol-based hand rub (ABHR) consumption as part of the regional performance indicator surveillance system. The aim of this study is to assess whether these two systems yield consistent results, i.e. whether numerical data matches the self-reported status of hand hygiene compliance. Methods For the years 2015-2018, data on ABHR consumption (in millilitres per patient-day, ml/PD) were collected annually at a facility level (40 hospitals) and then aggregated according to the corresponding local health unit/hospital unit, whereas the HHSAF scores were collected at a health/hospital unit level (18 units). The analysis was performed through logistic regression, by taking the WHO HHSAF score (continuous variable) as predictor and ABHR consumption as response variable, dichotomously considered as “low” or “high” (respectively below or above the 20 ml/PD threshold commonly accepted for good practice in hand hygiene). Results This study found that a high level of ABHR consumption is more likely to be observed in hospitals/health units with higher HHSAF scores, with a 1.14-fold increase in the odds for every 10-point increase in the HHSAF score. Despite the limited number of observations due to data aggregation, the result reached borderline statistical significance (p = 0.05). Conclusions The ABHR consumption surveillance provides feedback heading in the same direction as the results of the HHSAF, therefore the two surveillance systems are consistent. These findings provide further support for the validity of the HHSAF score as a reasonable predictor of hand hygiene compliance. Key messages The WHO Hand Hygiene Self-Assessment Framework score is a reliable predictor of hand hygiene compliance, as a high hand rub consumption is more likely to occur in hospitals with higher HHSAF score. Surveillance through the WHO HHSAF should be encouraged, along with alcohol-based hand rub (ABHR) measurement, and these results should be used to guide action plans to promote hand hygiene.

Usability of Hand Hygiene Observation Apps

2019 ◽  
Vol 8 (1) ◽  
pp. 275-278
Author(s):  
Amanda Sivek ◽  
Erin Sparnon ◽  
Patrice D Tremoulet
Keyword(s):  
Antibiotic Resistance ◽  
Hand Hygiene ◽  
Mobile Devices ◽  
Clinical Training ◽  
Hand Hygiene Compliance ◽  
Healthcare Associated Infections ◽  
Targeted Interventions ◽  
Hygiene Compliance ◽  
Healthcare Associated ◽  
The U.S

Effective hand hygiene among clinicians decreases the incidence of healthcare-associated infections and helps slow the rate of antibiotic resistance, but hand hygiene compliance (HHC) rates among clinicians is often low. Facility-wide HHC monitoring is required by the U.S. Centers for Medicare & Medicaid Services. In general, HHC monitoring is important to identify facility care areas, units or departments that have low HHC rates so that targeted interventions can be implemented. Recently several hand hygiene observation apps (HHOA), which enable observers to use mobile devices to record HHC data, have become available. The overall goal of our effort was to evaluate how helpful five different HHOAs were in supporting users in collecting and aggregating HHC data. Overall our participants, which included nine individuals with clinical training, and eight biomedical engineers found that all five HHOAs were fairly hard to use given that they have a relatively simple and straightforward function. There was an interesting interaction, however, with the biomedical engineers rating highest the HHOAs that the clinically-trained users rated lowest.

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