scholarly journals Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia

2009 ◽  
Vol 4 (02) ◽  
pp. 118-123 ◽  
Author(s):  
Supaletchimi Gopal Katherason ◽  
Lin Naing ◽  
Kamarudin Jaalam ◽  
Nik Abdullah Nik Mohamad ◽  
Kavita Bhojwani ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Intensive Care Units ◽  
Infection Control Practice ◽  
Hand Washing ◽  
Appropriate Use ◽  
Staff Members ◽  
Control Practice ◽  
Hygiene Practices ◽  
Before And After

Background: Hand decontamination is a critical infection control practice in the prevention of nosocomial infection. This study was conducted to observe the hand hygiene practices of nurses and doctors in two intensive care units (ICUs) in Malaysia. Methodology: Staff members were observed during patient contacts, and their hand washing techniques and hand hygiene practices were monitored. Five contact periods were observed for staff members while they cared for their assigned patients. Hand hygiene practices before and after patient contacts were categorized as clean uncontaminated, clean recontaminated, new gloves, and unchanged contaminated gloves. Compliance to hand-washing steps and time taken for hand washing were analyzed. Appropriate use of gloves based on CDC criteria also was assessed. Results: Compliance to hand hygiene practices was 70% before each patient contact. Staff members did not completely adhere to the hand-washing steps. The average time taken to wash hands was 20 seconds, and the necessary steps (rubbing palm over dorsum; rubbing fingers interlaced, and rotational rubbing of thumbs) were practiced minimally by all staff. Hand washing protocol was generally followed by all staff (100%). Alcohol hand rubs were available but were used moderately (60%); when used, staff members did not wait for the alcohol to dry. Only 4% of staff changed contaminated gloves between patients. Conclusions: Hand hygiene compliance by ICU staff members needs to be improved. Improving adherence to correct hand hygiene techniques will require effective education programs and behavioral modification techniques. Moreover, hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied.

scholarly journals Higienização das mãos em uma unidade de terapia intensiva neonatal

2021 ◽  
Vol 11 (34) ◽  
pp. 41-51
Author(s):  
Chiara Silmara Santos Silva ◽  
Alexandre Aguiar Pereira ◽  
Andressa Tavares Parente ◽  
Akyson Zidane Merca Silva ◽  
Edficher Margotti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care ◽  
Field Research ◽  
Care Process ◽  
Hygiene Practices ◽  
Before And After ◽  
Neonatal Icu ◽  
Terapia Intensiva ◽  
Relationship Of

Identificar, por meio da observação, a prática de higienização das mãos durante as ações cuidativas realizadas pela equipe de saúde ao recém-nascido pré-termo em UTI neonatal, traçando o perfil dos profissionais, registrando as práticas de higienização das mãos e avaliando a adesão ao uso do álcool gel e adorno zero. Trata-se de pesquisa de campo observacional, descritiva e exploratória, de natureza quantitativa. Amostra: 62 profissionais da saúde: enfermeiros, técnicos de enfermagem, médicos e fisioterapeutas. Realizadas 358 observações nos turnos: manhã, tarde e noite. Cerca de 64,52% dos profissionais tinham de 1 a 10 anos de atuação em Unidade de Terapia Intensiva Neonatal. Registrou-se que 88% realizaram higienização das mãos antes e depois à manipulação, com 93,85% de adesão ao adorno zero. Prima-se pela realização de educação permanente, reforçando a relação do processo de cuidado no cenário neonatal e seus impactos no prognóstico de saúde do RN.Descritores: Desinfecção das Mãos, Unidades de Terapia Intensiva Neonatal, Cuidados de Enfermagem. Hand hygienization in a neonatal intensive care unitAbstract: Identify, through observation, the practice of hand hygiene during the care actions performed by the health team to the preterm newborn in a neonatal ICU, tracing the profile of the professionals, recording hand hygiene practices and rating adherence to the use of hand sanitizer and zero adornment. It is an observational, descriptive and exploratory field research, of a quantitative nature. Sample: 62 health professionals: nurses, nursing technicians, doctors and physiotherapists. 358 observations were made in the shifts: morning, afternoon and night. Approximately 64.52% of professionals had 1 to 10 years of experience in the Neonatal Intensive Care Unit. It was registered that 88% performed hand hygiene before and after manipulation. With 93.85% adherence to zero adornment. It excels the realization of permanent education, reinforcing the relationship of the care process in the neonatal scenario and its impacts on the health prognosis of the newborn.Descriptors: Hand Disinfection, Intensive Care Units Neonatal, Nursing Care. Higienización de manos en una unidad de cuidado intensivo neonatalResumen: Identificar, por medio de la observación, la práctica de higienización de manos durante la labor por parte del equipo de salud al neonato prematuro en UCI neonatal, perfilando los profesionales, registrando las prácticas de higienización de manos y evaluando la adhesión a la utilización del alcohol gel y cero adornos. Se trata de una pesquisa de campo observacional, descriptiva, exploratória y de naturaleza cuantitativa. Amuestra: 62 profesionales del área de salud, de entre ellos, enfermeros, técnicos de enfermería, médicos y fisioterapeutas. Han sido realizadas 358 observaciones en los turnos: mañana, tarde y noche. Aproximadamente 64.52% de los profesionales tenían de 1 a 10 años de actuación en Unidades de Cuidado Intensivo Neonatal. Registramos que 88% realizaron higienización de manos antes y después de la manipulación y 93.85% no usaron adornos. Se estima por la realización de educación permanente, reforzando la relación al proceso de cuidado en el escenario neonatal y sus impactos en el pronóstico de salud del neonato.Descriptores: Desinfección de las Manos, Unidades de Cuidado Intensivo Neonatal, Atención de Enfermería.

scholarly journals 1156. Observation of Stethoscope Sanitation Practices in an Emergency Department Setting

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S348-S348
Author(s):  
Rajiv Vasudevan ◽  
Sean Mojaver ◽  
Kay-Won Chang ◽  
Alan Maisel ◽  
Romteen Sedighi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hand Hygiene ◽  
Significant Risk ◽  
Hand Washing ◽  
Medical Providers ◽  
Hand Sanitizer ◽  
Hygiene Practices ◽  
Patient Interaction ◽  
Emergency Department Setting ◽  
Before And After

Abstract Background Nosocomial infections pose significant risk to patients and hygienic standards may be easily overlooked, especially in fast-paced emergency department settings. Studies have shown that stethoscopes can harbor pathogens, which can be transferred to patients when proper sanitary measures are not taken. Survey-based studies have mostly assessed stethoscope hygiene, but they may not accurately represent cleaning practice. This study aimed to accurately assess cleaning practice through observation of stethoscope cleaning and hand hygiene among medical providers in an emergency department setting. Methods Four hundred twenty-six provider–patient encounters were observed in the emergency department of the VA San Diego Healthcare System. The frequency and methods of stethoscope and hand hygiene practices were anonymously observed and recorded. Stethoscope hygiene was recorded during and after each encounter if cleaning took place for at least 15 seconds. Hand hygiene data were also gathered before and after each encounter. Data analysis was performed to determine the frequency of these practices. Results Of 426 encounters, 115 involved the use of a personal stethoscope. In 15 of 115 encounters (13.0%), the provider placed a glove over the stethoscope before patient contact. Following patient interaction, 13 of 115 encounters (11.3%) involved stethoscope hygiene with an alcohol swab. Stethoscope hygiene with water and hand towel before patient interaction was observed in 5 of 115 encounters (4.3%). Hand sanitizer use or hand washing was observed in 213 of 426 encounters (50.0%) before patient interaction. Gloves were also used prior to patient interaction in 206 of 426 (48.4%) encounters, some overlapping with those who used hand sanitizer or washed their hands. Hand sanitizer or hand washing was used in 332 of 426 encounters (77.9%) after patient interaction. Conclusion Only 11.3% of encounters involving the use of a personal stethoscope had stethoscope sanitation with an alcohol swab. In 4.3% post-encounters, there was an attempt to clean stethoscopes with water and towel. Rates of appropriate hand hygiene were also lower than expected. Stethoscope and hand hygiene standards need to be raised to reduce infection risk and further studies need to be conducted to set guidelines for adequate stethoscope sanitation. Disclosures All authors: No reported disclosures.

scholarly journals Hand hygiene and the sequence of patient care

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.

Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project

2018 ◽  
Vol 8 (5) ◽  
pp. 408-413 ◽  
Author(s):  
Arunava Biswas ◽  
Sangeeta Das Bhattacharya ◽  
Arun Kumarendu Singh ◽  
Mallika Saha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Conceptual Framework ◽  
Neonatal Intensive Care ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Root Cause ◽  
Hygiene Compliance

Abstract Objective Our goal for this study was to quantify healthcare provider compliance with hand hygiene protocols and develop a conceptual framework for increasing hand hygiene compliance in a low-resource neonatal intensive care unit. Materials and Methods We developed a 3-phase intervention that involved departmental discussion, audit, and follow-up action. A 4-month unobtrusive audit during night and day shifts was performed. The audit results were presented, and a conceptual framework of barriers to and solutions for increasing hand hygiene compliance was developed collectively. Results A total of 1308 hand hygiene opportunities were observed. Among 1227 planned patient contacts, hand-washing events (707 [58.6%]), hand rub events (442 [36%]), and missed hand hygiene (78 [6.4%]) events were observed. The missed hand hygiene rate was 20% during resuscitation. Missed hand hygiene opportunities occurred 3.2 times (95% confidence interval, 1.9–5.3 times) more often during resuscitation procedures than during planned contact and 6.14 times (95% confidence interval, 2.36–16.01 times) more often when providers moved between patients. Structural and process determinants of hand hygiene noncompliance were identified through a root-cause analysis in which all members of the neonatal intensive care unit team participated. The mean hand-washing duration was 40 seconds. In 83% of cases, drying hands after washing was neglected. Hand recontamination after hand-washing was seen in 77% of the cases. Washing up to elbow level was observed in 27% of hand-wash events. After departmental review of the study results, hand rubs were placed at each bassinet to address these missed opportunities. Conclusions Hand hygiene was suboptimal during resuscitation procedures and between patient contacts. We developed a conceptual framework for improving hand hygiene through a root-cause analysis.

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