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 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 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 Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis

2016 ◽  
Vol 4 ◽  
pp. 205031211667509 ◽  
Author(s):  
Sheryl L Chatfield ◽  
Rachael Nolan ◽  
Hannah Crawford ◽  
Jeffrey S Hallam
Keyword(s):  
Hand Hygiene ◽  
Acute Care ◽  
Interpretative Phenomenological Analysis ◽  
Descriptive Analysis ◽  
The United States ◽  
Phenomenological Analysis ◽  
Healthcare Associated Infections ◽  
Hand Hygiene Improvement ◽  
Acute Care Nurses ◽  
Healthcare Associated

Objective: Occurrences of healthcare-associated infections are associated with substantial direct and indirect costs. Improvement in hand hygiene among acute care nurses has potential to reduce incidence of healthcare-associated infections. Findings from reviews of intervention research have not conclusively identified components that are more or less efficient or effective. Much prior qualitative research has focused on descriptive analysis of policies and practices rather than providing interpretive explorations of how individuals’ perceptions of hygiene might drive practices. Methods: We conducted qualitative interview research with eight nurses in the United States who were employed in various patient-care roles. We analyzed the data using an interpretative phenomenological analysis methodology to explore how nurses described their perceptions of, and experiences with, hygiene. We developed themes that explored individual, workplace, and management influences on perception of hygiene. Results: Developed themes include practical hygiene, risky business, and hygiene on trial; the latter theme described the conflict between how nurses perceived their own hygiene practices and how they felt hospital management perceived these practices. Other findings included that participants distinguished between policy-mandated use of sanitizer and a personal sense of cleanliness; the latter was more likely to be associated with scrubbing or removal of contaminants than with use of protectants. Conclusion: While participants asserted support for facility hand hygiene policies, their behavior in certain instances might be mediated by broadly defined emergent situations and a belief that it is not currently possible to establish a causal link between an healthcare-associated infections and a specific individual or occurrence. Researchers and infection prevention practitioners might consider soliciting greater input from nurses in planning hand hygiene improvement interventions, to encourage ownership, and emphasizing detailed cases as training content to take advantage of individuals’ sensory responses to hygiene.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2019 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Knowledge Score ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent Healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea.Methods: In a participatory approach, a team of HRF staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison.Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption.Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals 1190. Hygiene of the Hands 90/90: A Program of Continuous Improvement for the Compliance of the Hygiene of the Hands

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S427-S427
Author(s):  
Roxana Trejo ◽  
Solange G Koretzky
Keyword(s):  
Hand Hygiene ◽  
Health Workers ◽  
Medical Center ◽  
Hospital Staff ◽  
Healthcare Associated Infections ◽  
Total Cost ◽  
Short Period ◽  
Cheap Method ◽  
Healthcare Associated ◽  
Two Stages

Abstract Background Healthcare-associated infections (HAIs) are associated with high rates of morbidity and mortality, which translates into an increase in the days of hospitalization and costs of care. The research of hand hygiene in health workers demonstrate that this action decreases the spread of pathogens; however, the compliance of hand hygiene remains low among health workers. Hand hygiene is a cheap method to prevent infections. It has been estimated that the total cost of hand hygiene promotion represents <1% of the costs associated with the HAIs. Our goal is to strengthen the culture of hand hygiene (In and Out) in all health professionals in a period of 90 days, achieving a 90% compliance. Methods The ABC Medical Center is a high specialty hospital, on average it has 465 beds. The program led by the Epidemiology Unit was formed by a multidisciplinary team with the patriation of leaders of different areas (Epidemiology, Nursing, Physicians, Human resources, Quality and Teaching). We used the “WHO Guidelines on Hand Hygiene in Health Care” consisting of: (1) system change, (2) training for employees, (3) evaluation and feedback, (4) a reminder at the workplace, (5) institutional security climate, (6) monitoring of the compliance to hand hygiene: The monitoring of the evaluation personnel was carried out in two stages, when entering and leaving the patient’s room. Results A total of 9,732 observations were made, of which 55.32% went to the nursing staff, 22.80% to doctors and 21.87% to the hospital staff. The compliance of the hand hygiene at the beginning of the program was 70%, by the and the 91% was reached. Sustainability has been maintained through continuous campaigns of the importance of hand hygiene reaching a 98% adherence to hands hygiene in 2018. The behavior of HAIs is notorious since at the beginning of the program there was a rate of 0.95 and by 2018, with the increase in compliance to hand hygiene, it decreased to 0.56. Conclusion The 90/90 Hand Hygiene program is a pioneer in its modality for the implementation of the program in a short period of time and excellence in its scope. It is confirmed that leadership is essential and strategic to ensure quality and safety in patient care. Through the incentive to the staff a clear sense of participation and belonging to the institution is achieved Disclosures All authors: No reported disclosures.

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.

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