scholarly journals Hand hygiene practices and perceptions among healthcare workers in Ghana: A WASH intervention study

2019 ◽  
Vol 13 (12) ◽  
pp. 1076-1085 ◽  
Author(s):  
Appiah Labi ◽  
Noah Obeng-Nkrumah ◽  
Benjamin Demah Nuertey ◽  
Sheila Issahaku ◽  
Ndeye Fatou Ndiaye ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Relative Rate ◽  
Water Source ◽  
Relative Increase ◽  
Hygiene Practice ◽  
Post Intervention ◽  
Hygiene Practices ◽  
Hygiene Compliance

Introduction: We aimed to investigate whether the provision of water, sanitation, and hand hygiene (WASH) interventions were associated with changes in hand hygiene compliance and perceptions of healthcare workers towards infection control. Methodology: The study was conducted from June 2017 through February 2018 among healthcare workers in two Northern districts of Ghana. Using a pretest-posttest design, we performed hand hygiene observations and perception surveys at baseline (before the start of WASH interventions) and post-intervention (midline and endline). We assessed adherence to hand hygiene practice using the WHO direct observation tool. The perception study was conducted using the WHO perception survey for healthcare workers. Study outcomes were compared between baseline, midline and endline assessments. Results: The hand hygiene compliance significantly improved from 28.8% at baseline through 51.7% at midline (n = 726/1404; 95% CI: 49.1-54.2%) to 67.9% at endline (n = 1000/1471; 95% CI: 65.6-70.3%). The highest increase in compliance was to the WHO hand hygiene moment 5 after touching patients surrounding (relative increase, 205%; relative rate, 3.05; 95% CI: 2.23-4.04; p < 0.0001). Post-intervention, the top three policies deemed most effective at improving hand hygiene practice were: provision of water source (rated mean score, n = 6.1 ± 1.4), participation in educational activities (rated mean score 6.0 ± 1.5); and hand hygiene promotional campaign (6.0 ± 1.3). Conclusion: Hand hygiene compliance significantly improved post-intervention. Sustaining good hand hygiene practices in low resource settings should include education, the provision of essential supplies, and regular hand hygiene audits and feedback.

Hand Hygiene Compliance at Critical Points of Care

2020 ◽  
Author(s):  
Nai-Chung Nelson Chang ◽  
Heather Schacht Reisinger ◽  
Marin L Schweizer ◽  
ichael Jones ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Random Effect ◽  
Task Type ◽  
Resistant Bacteria ◽  
Improve Hand Hygiene ◽  
Hygiene Practices ◽  
Hygiene Compliance ◽  
Better Than

Abstract Background Most articles on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers (HCWs) are noncompliant. We assessed how task type affected HCWs’ hand hygiene compliance. Methods We linked consecutive tasks individual HCWs performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study into care sequences and identified task pairs—2 consecutive tasks and the intervening hand hygiene opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, HCW type, and compliance at prior opportunities. Results Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR], 0.97 [95% confidence interval {CI}, .95–.98]) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR, 1.12 [95% CI, 1.10–1.13]). Nurses were more likely to perform both critical and contaminating tasks, but nurses’ hand hygiene compliance was better than physicians’ (aOR, 0.94 [95% CI, .91–.97]) and other HCWs’ compliance (aOR, 0.87 [95% CI, .87–.94]). Conclusions Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.

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.

scholarly journals The Effectiveness of a Poster Intervention on Hand Hygiene Practice and Compliance When Using Public Restrooms in a University Setting

2019 ◽  
Vol 16 (24) ◽  
pp. 5036 ◽  
Author(s):  
Aaron Lawson ◽  
Marie Vaganay-Miller
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Hygiene Practice ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
University Population ◽  
Hygiene Compliance ◽  
The Uk ◽  
The University ◽  
Observation Period

Background: Most research on hand hygiene compliance in community settings indicates that compliance is poor. It is not conclusive as to whether poster interventions are effective at improving compliance. Methods: An independent, self-designed poster intervention was installed in one set of male and female public restrooms in a university campus in the UK. The hand hygiene practice and compliance of the university population was measured via indirect observation over a 60 day period. Results: During the pre-intervention observation period, 51.09% of the university population practiced basic hand hygiene compliance (washed hands with water, soap and dried afterwards), and 7.88% practiced adequate hand hygiene compliance (washed hands with water and soap for 20 s or more and dried afterwards for 20 s or more). During the post-intervention observation period, 55.39% of the university population were observed practicing basic hand hygiene compliance, and 7.97% practicing adequate hand hygiene compliance. Gender differences revealed that more females practiced basic hand hygiene in the post-intervention observation period (62.81%) than during the pre-intervention period (49.23%) and this was statistically significant (χ2 = 13.49, p = < 0.01). Discussion: The poster intervention had a limited effect on improving the basic and adequate hand hygiene compliance of the general population when using public restrooms. The use of independent, self-designed posters to improve hand hygiene practice and compliance is largely ineffective in the short term and should be used with caution in future intervention strategies.

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.

scholarly journals Access to Alcohol-Based Hand Rub Is Associated With Improved Hand Hygiene in an Ebola-Threatened District of Western Uganda

2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Wide Distribution ◽  
Patient Contact ◽  
Improve Hand Hygiene ◽  
Before And After ◽  
Hygiene Compliance ◽  
Handwashing With Soap

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan

scholarly journals Hand hygiene compliance in the intensive care unit of the Onderstepoort Veterinary Academic Hospital.

2019 ◽  
Author(s):  
Dikeledi Carol Sebola ◽  
Charlie Boucher ◽  
Caroline Maslo ◽  
Daniel Nenene Qekwana
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Infection Prevention And Control ◽  
Patient Contact ◽  
Academic Hospital ◽  
Hand Wash ◽  
Hygiene Compliance

Abstract Hand hygiene compliance remains the cornerstone of infection prevention and control (IPC) in healthcare facilities. However, there is a paucity of information on the level of IPC in veterinary health care facilities in South Africa. Therefore, this study evaluated hand hygiene compliance of healthcare workers and visitors in the intensive care unit (ICU) at the Onderstepoort Veterinary Academic Hospital (OVAH). Method: A cross-sectional study was conducted among healthcare workers (HCWs) and visitors in the ICU using the infection control assessment tool (ICAT) as stipulated by the South African National Department of Health. Direct observations using the “five hand hygiene moments” criteria as set out by the World helath Organisation were also recorded. The level of compliance and a 95% confidence interval were calculated for all variables. Results: Individual bottles of alcohol-based hand-rub solution and hand-wash basins with running water, soap dispensers, and paper towels were easily accessible and available at all times in the ICU. In total, 296 observations consisting of 734 hand hygiene opportunities were recorded. Hand hygiene compliance was also evaluated during invasive (51.4%) and non-invasive (48.6%) procedures. The overall hand hygiene compliance was 24.3% (178/734). In between patients, most HCWs did not sanitize stethoscopes, leashes, and cellular phones used. Additionally, the majority of HCWs wore jewellery below the elbows. The most common method of hand hygiene was hand-rub (58.4%), followed by hand-wash (41.6%). Nurses had a higher (44%) level of compliance compared to students (22%) and clinicians (15%). Compliance was also higher after body fluid exposure (42%) compared to after patient contact (32%), before patient contact (19%), after contact with patient surroundings (16%), and before an aseptic procedure (15%). Conclusion: Hand hygiene compliance in this study was low, raising concerns of potential transmission of hospital-acquired infections and zoonoses in the ICU. Therefore, it is essential that educational programs be developed to address the low level of hand hygiene in this study.

scholarly journals Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study

2020 ◽  
Vol 25 (5) ◽  
pp. 177-186
Author(s):  
Aaron Asibi Abuosi ◽  
Samuel Kaba Akoriyea ◽  
Gloria Ntow-Kummi ◽  
Joseph Akanuwe ◽  
Patience Aseweh Abor ◽  
...  
Keyword(s):  
Health Care ◽  
Observational Study ◽  
Hand Hygiene ◽  
Outcome Measures ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Job Aids ◽  
The Mean ◽  
Hygiene Compliance

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.

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