scholarly journals A qualitative study of hand hygiene compliance among health care workers in intensive care units

2019 ◽  
Vol 13 (02) ◽  
pp. 111-117 ◽  
Author(s):  
Pinar Ay ◽  
Ayse Gulsen Teker ◽  
Seyhan Hidiroglu ◽  
Pinar Tepe ◽  
Aysen Surmen ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hand Hygiene ◽  
Infection Control ◽  
Hand Hygiene Compliance ◽  
Training Model ◽  
Infection Control Team ◽  
Control Team ◽  
Quasi Experimental ◽  
One To One ◽  
Hygiene Compliance

Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.

scholarly journals “The role as a champion is to not only monitor but to speak out and to educate”: the contradictory roles of hand hygiene champions

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Cassie Cunningham Goedken ◽  
Daniel J. Livorsi ◽  
Michael Sauder ◽  
Mark W. Vander Weg ◽  
Emily E. Chasco ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Informal Education ◽  
Hand Hygiene Compliance ◽  
Ethnographic Study ◽  
Health Administration ◽  
Improve Hand Hygiene ◽  
Frontline Staff ◽  
Hygiene Compliance

Abstract Background Implementation science experts define champions as “supporting, marketing, and driving through an implementation, overcoming indifference or resistance that the intervention may provoke in an organization.” Many hospitals use designated clinical champions—often called “hand hygiene (HH) champions”—typically to improve hand hygiene compliance. We conducted an ethnographic examination of how infection control teams in the Veterans Health Administration (VHA) use the term “HH champion” and how they define the role. Methods An ethnographic study was conducted with infection control teams and frontline staff directly involved with hand hygiene across 10 geographically dispersed VHA facilities in the USA. Individual and group semi-structured interviews were conducted with hospital epidemiologists, infection preventionists, multi-drug-resistant organism (MDRO) program coordinators, and quality improvement specialists and frontline staff from June 2014 to September 2017. The team coded the transcripts using thematic content analysis content based on a codebook composed of inductive and deductive themes. Results A total of 173 healthcare workers participated in interviews from the 10 VHA facilities. All hand hygiene programs at each facility used the term HH champion to define a core element of their hand hygiene programs. While most described the role of HH champions as providing peer-to-peer coaching, delivering formal and informal education, and promoting hand hygiene, a majority also included hand hygiene surveillance. This conflation of implementation strategies led to contradictory responsibilities for HH champions. Participants described additional barriers to the role of HH champions, including competing priorities, staffing hierarchies, and turnover in the role. Conclusions Healthcare systems should consider narrowly defining the role of the HH champion as a dedicated individual whose mission is to overcome resistance and improve hand hygiene compliance—and differentiate it from the role of a “compliance auditor.” Returning to the traditional application of the implementation strategy may lead to overall improvements in hand hygiene and reduction of the transmission of healthcare-acquired infections.

scholarly journals Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study

2014 ◽  
Vol 100 (5) ◽  
pp. 454-459 ◽  
Author(s):  
Indah K Murni ◽  
Trevor Duke ◽  
Sharon Kinney ◽  
Andrew J Daley ◽  
Yati Soenarto
Keyword(s):  
Developing Countries ◽  
Hand Hygiene ◽  
Infection Control ◽  
Antibiotic Stewardship ◽  
Hand Hygiene Compliance ◽  
Antibiotic Use ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Rational Use Of Antibiotics ◽  
Hospital Acquired

BackgroundPrevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries.AimsTo implement a multifaceted infection control and antibiotic stewardship programme and evaluate its effectiveness on HAIs and antibiotic use.MethodsA before-and-after study was conducted over 27 months in a teaching hospital in Indonesia. All children admitted to the paediatric intensive care unit and paediatric wards were observed daily. Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of a hand hygiene campaign, antibiotic stewardship (using the WHO Pocket Book of Hospital Care for Children guidelines as standards of antibiotic prescribing for community-acquired infections), and other elementary infection control practices. Data were collected using an identical method in the preintervention and postintervention periods.ResultsWe observed a major reduction in HAIs, from 22.6% (277/1227 patients) in the preintervention period to 8.6% (123/1419 patients) in the postintervention period (relative risk (RR) (95% CI) 0.38 (0.31 to 0.46)). Inappropriate antibiotic use declined from 43% (336 of 780 patients who were prescribed antibiotics) to 20.6% (182 of 882 patients) (RR 0.46 (0.40 to 0.55)). Hand hygiene compliance increased from 18.9% (319/1690) to 62.9% (1125/1789) (RR 3.33 (2.99 to 3.70)). In-hospital mortality decreased from 10.4% (127/1227) to 8% (114/1419) (RR 0.78 (0.61 to 0.97)).ConclusionsMultifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised children in developing countries.

scholarly journals Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe

2013 ◽  
Vol 34 (4) ◽  
pp. 415-423 ◽  
Author(s):  
Victor D. Rosenthal ◽  
Mandakini Pawar ◽  
Hakan Leblebicioglu ◽  
Josephine Anne Navoa-Ng ◽  
Wilmer Villamil-Gómez ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Performance Feedback ◽  
Hand Hygiene Compliance ◽  
Administrative Support ◽  
Univariate Analysis ◽  
Limited Resource ◽  
Improve Hand Hygiene ◽  
Hygiene Compliance

Objective.To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multi-dimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.Design.An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.Setting.Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.Participants.Healthcare workers at 99 ICU members of the INICC.Methods.A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.Results.A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P<.001), physicians versus nurses (62% vs 72%; P<.001), and adult versus neonatal ICUs (67% vs 81%; P<.001), among others.Conclusions.Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented.

scholarly journals Impact of Replacing Powdered Gloves With Powder-free Gloves on Hand-hygiene Compliance Among Healthcare Workers of an Intensive Care Unit: a Quasi-experimental Study

2020 ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Fernando Bellissimo-Rodrigues ◽  
Marcia A. Ciol ◽  
Maria Auxiliadora-Martins ◽  
Anibal Basile-Filho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Experimental Study ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Latex Gloves ◽  
Before And After ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
Powdered Latex Gloves

Abstract Background/Objective. After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). Methods. A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization (WHO) Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention.Results. Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% Confidence Interval [CI]: 51-59%) using powdered latex gloves and 60% (95% CI: 57-63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI: 2.5-7.6%, p<0.001).Conclusion. Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

The effect of random voice hand hygiene messages delivered by medical, nursing, and infection control staff on hand hygiene compliance in intensive care

2006 ◽  
Vol 34 (10) ◽  
pp. 673-675 ◽  
Author(s):  
Maryanne McGuckin ◽  
Arlene Shubin ◽  
Patricia McBride ◽  
Stephen Lane ◽  
Kevin Strauss ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Infection Control ◽  
Hand Hygiene Compliance ◽  
Hygiene Compliance

“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

2021 ◽  
pp. 1-5
Author(s):  
Paritosh Prasad ◽  
Lynne Brown ◽  
Shiyang Ma ◽  
Andrew McDavid ◽  
Andrew Rudmann ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Fold Increase ◽  
Credible Interval ◽  
Clostridioides Difficile ◽  
Before And After ◽  
Clostridioides Difficile Infection ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
Hospital Acquired

Abstract Objective: To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. Design: We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. Settings: The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. Patients: All adult inpatients with the exception of patients in the obstetrics unit. Interventions: A hospital-wide universal gloving protocol was initiated on January 1, 2016. Results: Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12–1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). Conclusion: A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

scholarly journals Barriers to Hand Hygiene Compliance in Intensive Care Units From the Perspective of Healthcare Workers: A Qualitative Study

2021 ◽  
Author(s):  
Parvin Mangolian shahrbabaki ◽  
Mahlagha Dehghan ◽  
Mehdi Ahmadinejad ◽  
Maryam jabarpour ◽  
Mahbubeh Mazallahi
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
Hand Hygiene ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Physical Space ◽  
Main Theme ◽  
Hygiene Practice ◽  
Hygiene Compliance

Abstract Background: Hand hygiene is one of the simplest and most important ways to prevent nosocomial infections. However, the available evidence indicates that hand hygiene is not fully practiced by healthcare workers. Several factors affect hand hygiene. Therefore, this study aimed to explain the experiences of healthcare workers in the barriers to hand hygiene compliance in intensive care units.Methods: This qualitative study was performed on 25 doctors, anesthesiologists, nurses and physiotherapists working in intensive care units by using purposive sampling and semi-structured individual interviews. The data analysis process was performed with Lundman and Graneheim approach.Results: The main theme of “barriers to hand hygiene practice” with three main categories, including 1- barriers related to healthcare providers with subcategories of workload, insufficient knowledge, inappropriate attitude and wrong behavioral patterns, 2- barriers related to management with the subcategories of improper planning and training, improper design of the physical space of the department and 3- barriers related to equipment and facilities with the subcategories of lack of equipment and poor quality equipment were identified in this study.Conclusion: The results of the present study can help the relevant authorities in adopting appropriate strategies to remove barriers to hand hygiene practice and promote the right attitude and behavior in healthcare workers.

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