Hand hygiene promotion delivered by change agents—Two attitudes, similar outcome

2020 ◽  
Vol 41 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Yew Fong Lee ◽  
Mary-Louise McLaws ◽  
Loke Meng Ong ◽  
Suraya Amir Husin ◽  
Hock Hin Chua ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Tertiary Care ◽  
Change Agents ◽  
Controlled Study ◽  
Care Hospital ◽  
Hand Hygiene Improvement ◽  
Significant Difference ◽  
Hygiene Promotion ◽  
Hygiene Compliance

AbstractObjective:To assess the effect of peer-identified change agents (PICAs) compared to management-selected change agents (MSCAs) on hand hygiene behavior in acute care.Design:Randomized-controlled study.Setting:Two internal medicine wards of a public, university-affiliated, tertiary-care hospital in Malaysia.Methods:We randomly allocated 2 wards to hand hygiene promotion delivered either by PICAs (study arm 1) or by MSCAs (study arm 2). The primary outcome was hand hygiene compliance using direct observation by validated auditors. Secondary outcomes were hand hygiene knowledge and observations from ward tours.Results:Mean hand hygiene compliance in study arm 1 and study arm 2 improved from 48% (95% confidence interval [CI], 44%–53%) and 50% (95% CI, 44%–55%) in the preintervention period to 66% (63%–69%) and 65% (60%–69%) in the intervention period, respectively. We detected no statistically significant difference in hand hygiene improvement between the 2 study arms. Knowledge scores on hand hygiene in study arm 1 and study arm 2 improved from 60% and 63% to 98% and 93%, respectively. Staff in study arm 1 improved hand hygiene because they did not want to disappoint the efforts taken by the PICAs. Staff in study arm 2 felt pressured by the MSCAs to comply with hand hygiene to obtain good overall performance appraisals.Conclusion:Although the attitude of PICAs and MSCAs in terms of leadership, mode of action and perception of their task by staff were very different, or even opposed, both PICAs and MSCAs effectively changed behavior of staff toward improved hand hygiene to comparable levels.

scholarly journals 1195. Hand Hygiene Compliance of Patients’ Family Members in India: Importance of Educating the Unofficial “Fourth Category” of Healthcare Personnel

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S429-S429
Author(s):  
Manisha Biswal ◽  
Archana Angrup ◽  
Surria Rajpoot ◽  
Rupinder Kaur ◽  
Kulbeer Kaur ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Tertiary Care ◽  
Family Members ◽  
Hospital Setting ◽  
Healthcare Personnel ◽  
Care Hospital ◽  
Awareness Campaigns ◽  
Hygiene Compliance ◽  
The Impact

Abstract Background In India,due to manpower constraints, patients’ family members are often actively involved in healthcare activities of their near and dear ones. They have significant contact with the patient at all the 5 moments for hand hygiene (HH) as listed by WHO. At our tertiary care hospital in north India, we have been monitoring HH compliance (HHC) for nearly a decade. In this study, we analyzed the impact of decade long awareness campaigns to improve HH compliance in our patients’ attendants. Methods Trained infection control nurses directly observed the compliance to hand hygiene at each of the five moments for patients’ attendants over different areas of the hospital over a period of 5 years (January 2014–December 2018). Compliance was calculated as percentage of events over total opportunities and compared. Results 7290 opportunities were observed with an overall compliance of 46.3%. The overall HHC in patient attendants has increased from 35.5% in 2014 to 48.2% in 2018 (P < 0.0001). Compliance at WHO moment 1, 2, 3, 4 and 5 was 51.2%, 47.8%, 67.8%, 48.9% and 24.4% respectively. Among family members, mothers of newborn babies had a much higher HHC (77%) than others (44.7%) (P < 0.0001). Also, the compliance was higher in medical vs. surgical wards and pediatric wards vs. adult wards (P < 0.0001 in both). Conclusion This is the first study about family members’ HHC in a hospital setting in a low and middle-income country. Once trained, family members exhibit fairly good hand hygiene compliance while involved in healthcare activities of their patients. Mothers of newborn babies exhibit exemplary hand hygiene compliance while caring for their babies in our hospital. It is worthwhile empowering and educating patient attendants about the importance and process of hand hygiene as it is likely to result in immense benefit for patients. Disclosures All authors: No reported disclosures.

scholarly journals The Trend of Device-Associated Hospital Acquired Infections in an Adult Intensive Care Unit of a Tertiary Care Hospital: A Need to Revamp Preventive Strategies

2021 ◽  
Vol 6 (3) ◽  
pp. 98-104
Author(s):  
Bineeta Kashyap ◽  
Rajat Jhamb ◽  
Rituparna Saha ◽  
Pratima Prasad
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Blood Stream ◽  
Central Line ◽  
Care Hospital ◽  
Adult Intensive Care Unit ◽  
Hygiene Compliance

Background: Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs). Objectives: The study aims to elucidate their trends in an adult ICU. Methods: Over 21 months, monthly VAP, CLABSI, and CAUTI rate, and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. All cases of VAP, CLABSI, and CAUTI during these 21 months were included. In addition, monthly hand hygiene compliance rates were assessed during the latter period of the study by direct observation method. Results: Nosocomial DAI rate was 49.38 DAI/1000 ICU days. CAUTI, CLABSI, and VAP rates were 17.38, 26.85, 21.08 per 1000 device days, and device utilization ratios were 0.99, 0.61, and 0.02, respectively. Conclusion: The institute had high DAI rates in comparison to other studies from the same city. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. Thus, it establishes baseline data and underscores the need for focused HIC to maximize patient outcomes.

scholarly journals A COMPARISON OF HAND HYGIENE PRACTICES USING “RING THE BELL”; A LOW COST HIGH IMPACT INNOVATIVE TOOL

2020 ◽  
pp. 1-4
Author(s):  
Anand S Kannapur ◽  
Sudarshan Naik
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Low Cost ◽  
Tertiary Care ◽  
Medical Personnel ◽  
High Impact ◽  
P Value ◽  
Care Hospital ◽  
Innovative Tool ◽  
Hygiene Compliance

RATIONALE: Hand hygiene is one of the most neglected practices amongst health care personnel. We devised a positive habit reinforcement tool called “ring the bell” and hypothesized that it will not lead to better hand hygiene compliance. OBJECTIVES: Hand hygiene events (hand washing and hand rub) of two Intensive Care Units (ICUs) of a large tertiary care hospital were compared. METHODS: For purpose of the study the control limb was designated ICU A and the test limb ICU B. All medical personnel in ICU B were instructed to “ring the bell” hung next to the wash basin prior to washing hands. MEASUREMENTS: The study was performed for one hour a day over a period of 90 days and numbers of hand hygiene events were recorded by obscure observers. MAIN RESULTS: Total hand hygiene events of ICU A were 909 out of 1584 (0.58%) medical personnel attending and in ICU B were 3870 out of 2706 (1.43%) medical personnel attending, a signicant increase of more than 125% (2.5 times). The two sided Z test was applied and Z value was calculated to be 12.34 (SE=0.068). Since p value (0.0001) was less than 0.05, we rejected the null hypothesis at 5% level of signicance. CONCLUSION(S): “Ring the bell” campaign used for positive habit reinforcement effectively increased hand hygiene compliance and such a low cost and high impact innovative tool is strongly recommended to improve safety and quality of medical care in order to prevent nosocomial infections.

Oral paracetamol versus zolmitriptan to treat acute migraine attack in the emergency department

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Rescue Therapy ◽  
Tertiary Care ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Care Hospital ◽  
Acute Migraine ◽  
Pain Scores ◽  
Significant Difference

Background: Treatment provided in an emergency department is aimed at alleviating pain immediately with minimized adverse effects as well as warding off further migraine attacks. The primary aim of this article is to compare the effectiveness of oral paracetamol versus zolmitriptan in treating acute migraine attacks. Methods: This prospective, randomized, and controlled study was carried out at a tertiary care hospital visited by 95,000 patients annually. The study recruited 200 participants who were randomized into two groups. One group received 1000 mg paracetamol while the other group received 2.5 mg zolmitriptan orally. Baseline pain scores were recorded using the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 15, 30 and at 60 min following administration of the study drugs. Patients requiring further treatment were provided fentanyl at a dosage of 1 µg/kg as a rescue therapy. Results: A significant decrease was evident in VAS and NRS scores following the administration of the study drugs in both groups (P < 0.001). The change in VAS pain scores after 15, 30 and 60 min was calculated as 17.0 ± 13.9, 41.2 ± 16.3 and 61.2 ± 17.5 mm, respectively, in the paracetamol group and 14.2 ± 11.7, 39.2 ± 17.9 and 59.2± 19.3 mm, respectively, in the zolmitriptan group, which did not indicate significant differences (P = 0.103, P = 0.425, P = 0.483, respectively). Likewise, NRS pain scores showed a downward trend in line with VAS pain scores and did not yield a significant difference (P = 0.422). No significant difference concerning rescue therapy was noted between the two groups (P = 0.596). Conclusion: Oral paracetamol and zolmitriptan prove to be similarly effective and have low incidence of acute side effects in treating acute migraine cases without aura.

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