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Lee M, Park SW, Bang J, Lee E. Impact of medical waste bin on contamination of patient's environment: an experimental study. Am J Infect Control 2024:S0196-6553(24)00158-5. [PMID: 38588979 DOI: 10.1016/j.ajic.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Medical waste bins are potential source of microbial contamination in hospital environment, while there is no clear guidance for the management of them. We aimed to assess the impact of medical waste bins on patient's environment. METHODS This experimental study simulated microbial contamination by performing medical procedures on a patient model with fluorescent lotion. The waste bin was set as initially empty or two-thirds filled with waste, open or with a lid. The percentage of fluorescent contaminated area in designated patient's environments was analyzed by two independent observers. RESULTS Among a total of 120 experiments, the sides of the bins were more contaminated in open-occupied bins compared to open-empty bins and in open-occupied bins compared to lid-occupied bins (median 1.9175% vs. 0.0916% [P=0.001] and 1.9175% vs. 0.0899% [P=0.003], respectively). The top of bedside equipment trolley for preparing medical procedure was more contaminated in lid-occupied bins than open-occupied bins (median 0.0080% vs. 0.0040%, P=0.013). DISCUSSION In addition to reducing contamination of bin itself, the manually operated lid had potential risk of contributing microbial transmission by contaminating equipment trolley. CONCLUSIONS Medical waste bin should be kept no more than two-thirds full, and cautions should be taken when using manually operated lid, to avoid cross-contamination.
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Affiliation(s)
- Minkyeong Lee
- Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Won Park
- Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Jihwan Bang
- Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Eunyoung Lee
- Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea.
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Daba C, Atamo A, Debela SA, Gebrehiwot M. Observational assessment of hand hygiene compliance among healthcare workers in public hospitals of Northeastern Ethiopia. Int J Environ Health Res 2024; 34:792-802. [PMID: 36689677 DOI: 10.1080/09603123.2023.2168629] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6-48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2-2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3-5.4), work overload (AOR = 2.5; 95%CI: 1.9-4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1-4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2-4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5-4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals' managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amanuel Atamo
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Abebe Debela
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Daba C, Atamo A, Gebretsadik Weldehanna D, Oli A, Debela SA, Luke AO, Gebrehiwot M. Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia. BMJ Open 2023; 13:e074492. [PMID: 38159945 PMCID: PMC10759124 DOI: 10.1136/bmjopen-2023-074492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Non-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19 IPC compliance among healthcare workers in conflict-affected settings. The objective of this research was to assess compliance with COVID-19 IPC measures and determine the factors associated with it among healthcare providers in Ethiopian governmental hospitals affected by conflict. DESIGN A cross-sectional study was carried out within institutional settings. STUDY SETTING AND PERIOD The study was conducted in three public hospitals located in northeastern Ethiopia during the period of March to April 2022. PARTICIPANTS Simple random sampling technique was used to select 325 healthcare workers after proportional allocation was made to each public hospital. PRIMARY OUTCOME MEASURES The primary outcome was non-compliance with COVID-19 IPC. A multivariable logistic regression analysis was employed to identify factors associated with the lack of adherence to the COVID-19 IPC protocol. RESULTS Nearly half (150, 46.2%) of the healthcare workers had non-compliance with COVID-19 IPC protocol. Absence of hand washing soap (adjusted OR (AOR)=2.99; 95% CI 2.46 to 5.76), workload (AOR=2.25; 95% CI 1.33 to 3.84), disruption in the supply of piped water (AOR=1.82; 95% CI 1.11 to 2.99), did not undergo training in COVID-19 IPC (AOR=2.85; 95% CI 1.85 to 4.84), absence of COVID-19 IPC guidelines (AOR=2.14; 95% CI 1.11 to 4.13) and chewing khat (AOR=2.3; 95% CI 1.32 to 3.72) were determinant factors for non-compliance. CONCLUSIONS The magnitude of non-compliance with COVID-19 IPC was high. Hospital managers and federal ministry of health should provide regular training on COVID-19 IPC, continuous piped water and personal protective facilities for healthcare workers. Ultimately, improving the security situation in the area would help improve COVID-19 IPC compliance among healthcare workers in these and other similar conflict-affected settings.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amanuel Atamo
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik Weldehanna
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abdi Oli
- Department of Mathemathics, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Abebe Debela
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Amana Ogeto Luke
- Department of Public Health, Lancha Campus, Rift Valley University, Addis Ababa, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Bilgin H, Sili U, Pazar N, Kucuker I, Kepenekli E, Yanar MA, Memisoglu A, Ozek E, Adhikari NK, Pinto R, Korten V. Effect of video camera monitoring feedback on hand hygiene compliance in neonatal intensive care unit, an interventional study. Am J Infect Control 2023; 51:1028-1033. [PMID: 36603809 DOI: 10.1016/j.ajic.2022.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether use of a video camera surveillance system for hand hygiene (HH) monitoring, video-based education, and feedback could improve the HH compliance in a neonatal intensive care unit (NICU). METHODS AND MATERIALS This was an interventional before-after trial conducted in a level-III NICU between July 2019 and June 2020. HH compliance was measured using randomly selected video-camera footage in the baseline, intervention, and maintenance periods. After the baseline, an intervention consisting of feedback and education with video scenarios was implemented. The primary outcome was change in HH compliance. The compliance rates were analyzed as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study period. RESULTS We identified a total of 8335 HH indications. There were non significant increases in the total compliance rate (9.0%, 95% CI -2% to 20%) at the time of intervention and in the compliance rate after intervention (0.26%, 95% CI -0.31% to 0.84%) per day. The hand hygiene compliance before patient contact significantly increased (19.8%, 95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention (-3.4%, 95% CI -13.4% to 6.7%). CONCLUSION In this study of HH monitoring using video-camera footage combined with an intervention including feedback and education, there were inconsistent improvements in HH compliance. However, these improvements were not sustained in the long term. Frequent feedback and education may be required to sustain high compliance.
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Affiliation(s)
- Huseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey.
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nazli Pazar
- Infection Prevention and Control, Marmara University Hospital, Istanbul, Turkey
| | - Isil Kucuker
- Infection Prevention and Control, Marmara University Hospital, Istanbul, Turkey
| | - Eda Kepenekli
- Department of Pediatric Infectious Diseases and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Meral Agirman Yanar
- Department of Neonatal Intensive Care Unit, Marmara University School of Medicine, Istanbul, Turkey
| | - Asli Memisoglu
- Department of Neonatal Intensive Care Unit, Marmara University School of Medicine, Istanbul, Turkey
| | - Eren Ozek
- Department of Neonatal Intensive Care Unit, Marmara University School of Medicine, Istanbul, Turkey
| | - Neill Kj Adhikari
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Ruxandra Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
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Aldawsari M, Soh KL, Abdul Raman R, Mohd Taib N, Aboshaiqah A. Knowledge, Attitude and Practice of Hand Hygiene among Healthcare Workers Caring for Children with Leukaemia in the Paediatric Oncology Ward of King Saud Medical City, Saudi Arabia. Malays J Med Sci 2023; 30:116-131. [PMID: 37655141 PMCID: PMC10467590 DOI: 10.21315/mjms2023.30.4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/06/2023] [Indexed: 09/02/2023] Open
Abstract
Background Hands are the most common vehicle of pathogen transmission in a healthcare setting. Therefore, hand hygiene is the leading method of reducing healthcare-associated infections. This study aimed to determine the knowledge, attitude and practice (KAP) of hand hygiene and predictors for poor hand hygiene practice among healthcare workers who care for children with leukaemia in the paediatric oncology ward of King Saud Medical City (KSMC) in Saudi Arabia. Methods One hundred and ninety medical doctors and nurses, who were registered with the Saudi Commission for Health Specialities, were selected to participate in this cross-sectional study using a simple sampling technique. Their KAP of hand hygiene was assessed using a self-structured questionnaire and the collected data was analysed using IBM® SPSS® version 26.0. Results Of the 190 healthcare workers, 74.7% were nurses and 25.3% were medical doctors. Among the participants, 53.7% (102) had good knowledge of hand hygiene, 51.6% (98) had positive attitudes towards hand hygiene and 55.8% (106) practised satisfactory hand hygiene. Bachelor education level (adjusted OR = 2.736; 95% CI = 1.101, 6.799; P = 0.030), postgraduate education level (adjusted OR = 6.256; 95% CI = 2.171, 18.028; P = 0.001), poor knowledge (adjusted OR =2.575; 95% CI = 1.263, 5.246; P = 0.009) and negative attitude (adjusted OR = 4.702; 95% CI = 1.263, 5.246; P < 0.001) were the significant predictor variables of unsatisfactory hand hygiene practice among healthcare workers. Conclusion The performance of hand hygiene among healthcare workers is still far less than optimal, particularly in settings like oncology units. Effective programmes are needed to increase their awareness of hand hygiene KAP, while strict guidelines are needed to reduce nosocomial infections.
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Affiliation(s)
- Mujibah Aldawsari
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Rosna Abdul Raman
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Niazlin Mohd Taib
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Sharma M, Bachani R. Knowledge, Attitude, Practice, and Perceived Barriers for the Compliance of Standard Precautions among Medical and Nursing Students in Central India. Int J Environ Res Public Health 2023; 20:5487. [PMID: 37107771 PMCID: PMC10139079 DOI: 10.3390/ijerph20085487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES The aim of this study was to assess and compare (a) the knowledge, attitude, and practice of standard precautions (SPs), (b) the knowledge of post-exposure management, and (c) the perceived barriers underlying the noncompliance with SPs among future healthcare professionals (HCPs), i.e., students of medical and nursing courses in Central India. SETTING AND PARTICIPANTS A cross-sectional study was conducted in 2017-2018 among students of a medical and a nursing college using a pretested and modified questionnaire. Data were collected during 23 face-to-face sessions. Responses were scored according to standard guidelines of the Centers for Disease Control and Prevention and WHO, where each correct response was given a score of 1. RESULTS Among 600 participants, 51% of medical students and 75% of nursing students could not select the correct definition of SPs from the given options. Sixty-five percent of medical students (275/423) and 82% of nursing students (145/177) were unaware of the term post-exposure prophylaxis. Overall, knowledge about personal protective equipment and hazard symbols was poor (<25%). Furthermore, although theoretical knowledge about hand hygiene was good (510/600; 85%), its implementation was poor (<30%). Sixty-four percent of participants believed that the use of hand rub replaced the need for handwashing, even for visibly soiled hands. Some of the participants believed that the use of PPE might offend patients (16%). High workload and poor knowledge were other significant barriers underlying the noncompliance with SPs. CONCLUSIONS A suboptimal translation of participants' knowledge into practice is evident and signifies the presence of the know-do gap. Poor knowledge and inappropriate presumptions about the use of SPs discourage the practice of SPs. This results in increased healthcare-associated infections, increased treatment costs, and a suppressed social economy. The inclusion of a dedicated curriculum with repeated hands-on and practice-based training on SPs is suggested to minimize this know-do gap among future healthcare workers.
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Affiliation(s)
- Megha Sharma
- Department of Pharmacology, R. D. Gardi Medical College, Ujjain 456006, MP, India
- Department of Global Public Health-Health Systems and Policy: Medicines, Karolinska Institutet, 171 77 Stockholm, Sweden
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Krishnamoorthy Y, M K, Kuberan D, Krishnan M, Tondare D. Compliance with hand hygiene practices and its appropriateness among healthcare workers during COVID-19 pandemic in public health facilities of Tamil Nadu, India. Heliyon 2023; 9:e15410. [PMID: 37089396 PMCID: PMC10104598 DOI: 10.1016/j.heliyon.2023.e15410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
Background Compliance with appropriate hand hygiene practises is the most efficient and cost-effective intervention that can be implemented in the healthcare setting. Given its importance, we tried to capture the compliance with hand hygiene practises and their appropriateness among healthcare workers during the COVID-19 pandemic in public health facilities in Tamil Nadu. Methods This cross-sectional study involved doctors, nurses, and allied healthcare professionals from various departments in 18 public healthcare facilities spanning six districts in Tamil Nadu. A random-intercept model was employed for the multivariable logistic regression analysis to evaluate the factors influencing hand hygiene compliance and its adequacy. The effect size was presented as an adjusted odds ratio (aOR) accompanied by a 95% confidence interval (CI). Results In total, 2733 hand hygiene observations were made. Only during 19.4% (95%CI: 17.9%-20.9%) of these observations, hand washing was done. Only during 37.9% (95%CI: 33.9%-42.1%) of these observations, hand washing was done appropriately by following all the essential steps of hand hygiene. Nurses (aOR = 2.49; 95%CI: 1.90-3.26), healthcare workers in General Surgery (aOR = 2.18; 95%CI: 1.53-3.10) and Obstetrics & Gynaecology departments (aOR = 1.75; 95%CI: 1.26-2.43), working in inpatient departments (aOR = 2.64; 95%CI: 1.38-5.04) had significantly higher compliance to hand hygiene practices. Nurses (aOR = 2.58; 95%CI: 1.33-5.01) and General Medicine department healthcare workers (aOR = 1.98; 95%CI: 1.09-3.61) had significantly higher compliance to appropriate hand hygiene practices. Conclusion Our study shows that only during one-fifth of the observations did healthcare workers do hand washing, and less than 10% did it appropriately by following all the essential steps of hand hygiene.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Kala M
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Deivasigamani Kuberan
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Murali Krishnan
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Devidas Tondare
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
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Manzo BF, Silva DCZ, Fonseca MP, Tavares IVR, de Oliveira Marcatto J, da Mata LRF, Parker LA. Content validity of a Safe Nursing Care Checklist for a neonatal unit. Nurs Crit Care 2023; 28:307-321. [PMID: 35920678 DOI: 10.1111/nicc.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Nursing checklists have been shown to improve communication, reduce the occurrence of adverse events, and promote safe, quality care in different care settings. However, to date, there is no validated patient care safety checklist for nurses caring for infants in Neonatal Intensive Care Units (NICU). AIM To describe development and content validation of the "Safe Nursing Care Checklist for Infants Hospitalized in the Neonatal Intensive Care Unit". STUDY DESIGN Online Survey. METHODS Based upon an integrative literature review, we developed a checklist focused on safe nursing care for infants in the NICU. Nursing experts participated in three rounds of a content validation process where they rated the items online. An agreement level ≥0.90 was required for inclusion in the checklist. Forty- three expert nurses with experience working in the NICU and who were certified in neonatal nursing or had a master's or doctoratal degree in child health provided content validation of the patient care checklist. RESULTS The final checklist contained 45 items with content validation index scores greater than 90%. The instrument was structured into six dimensions including patient identification, effective communication, medication safety, infection prevention, fall prevention, and pressure injuries/skin injuries prevention. CONCLUSION Content validity was established for the "Safe Nursing Care Checklist for Infants Hospitalized in the Neonatal Intensive Care Unit" which can identify strengths and weaknesses in safe nursing care for infants in the NICU as well as direct educational interventions to promote nursing care based on scientific evidence. RELEVANCE TO CLINICAL PRACTICE This checklist can potentially be used by bedside nurses to promote provision of safe care to infants in the NICU and to guide corrective strategies and encourage evidence-based decision-making. Validation in the clinical setting is needed.
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Affiliation(s)
- Bruna Figueiredo Manzo
- Department of Maternal Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Juliana de Oliveira Marcatto
- Department of Maternal Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Leslie A Parker
- Department of Biobehavioval Nursing Science, University of Florida College of Nursing, Gainesville, Florida, USA
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Kopsidas I, De Luca M, Bielicki J, Blázquez-Gamero D, von Both U, Ciliento G, Epalza C, Goycochea Validivia WA, Kolberg L, Lutsar I, Machaira M, Neth O, Oletto A, Tsolia MN, Viltrop AL, Zaoutis T, Spyridis N. Hand Hygiene Compliance Rates in 9 Pediatric Intensive Care Units Across Europe: Results from the Reducing Antimicrobial use and Nosocomial Infections in Kids Network. Pediatr Infect Dis J 2022; 41:e434-7. [PMID: 35939607 DOI: 10.1097/INF.0000000000003658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A unified surveillance mechanism for hand hygiene and hospital-acquired infections for pediatric wards is lacking in Europe. We managed to setup such a mechanism in 9 pediatric intensive care units in 7 European countries, using World Health Organization's definitions and common methodology which allows for benchmarking among units and countries. Median hand hygiene compliance was found high 82.3% (interquartile range 71.6-94.5%), but gaps in practices were identified.
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Jerbi RS, Said AI, Elhamadi MR. Compliance of Nurses with Hand Hygiene Guidelines in Tripoli University Hospital, 2019. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1749136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Background Health care-associated infections (HAIs) result in high morbidity, decreased personal satisfaction, and mortality. Implementing infection prevention and control strategies such as hand hygiene (HH) promotion is critical to reduce the risk of the HAI and protect patients.
Aims This study aimed to determine the compliance rate of HH among nurses in Tripoli University Hospital (TUH, previously known as Tripoli Medical Center).
Method A cross-sectional study was conducted in different departments at TUH, starting from May 1st to October 31st, 2019. An observational checklist based on the “five moments for hand hygiene” of World Health Organization (WHO) was used. There were 271 nurses who interacted with 1,213 patients, a total of 3,452 HH episodes, and 6,065 cases of HH that were collected in this study, and data were statistically analyzed.
Results The overall HH compliance rate was 56.9%. Most of the nurses (86%) preferred to use HH after contact with individual patients and 71.6% after contact with patients' environment. There was, however, low percentage of HH prior to patient contact (35.1%). The compliance rate was higher among nurses of the age group of less than 20 years (60.8%), non-Libyan (60.7%), and those who received formal training (60.5%).
Conclusion In general, the HH compliance rate was low among nurses working in TUH. Education is an important factor that impacts the practice of HH pre- and postpatient contact. Wider studies that include assessment of pre- and posteducation courses should be conducted in the future.
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Affiliation(s)
- Rehab S. Jerbi
- Faculty of Medicine, Department of Family and Community Medicine, University of Tripoli, Tripoli, Libya
| | | | - Miluda R. Elhamadi
- Faculty of Medicine, Department of Family and Community Medicine, University of Tripoli, Tripoli, Libya
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Nzanga M, Panulo M, Morse T, Chidziwisano K. Adherence to Hand Hygiene among Nurses and Clinicians at Chiradzulu District Hospital, Southern Malawi. Int J Environ Res Public Health 2022; 19:ijerph191710981. [PMID: 36078689 PMCID: PMC9518139 DOI: 10.3390/ijerph191710981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 05/31/2023]
Abstract
Healthcare associated infections (HAIs) are a burden in many countries especially low-income countries due to poor hand hygiene practices in the healthcare settings. Proper hand hygiene in the healthcare setting is an effective way of preventing and reducing HAIs, and is an integral component of infection prevention and control. The objective of this study was to determine adherence to hand hygiene guidelines and associated factors among nurses and clinicians. A quantitative cross-sectional study was conducted at Chiradzulu District Hospital (Malawi) where stratified random sampling was used to obtain the sample of 75 nurses and clinicians. Data were collected using self-administered questionnaires (n = 75), observation checklists (n = 7) and structured observations (n = 566). The study findings confirmed low adherence to hand hygiene practice among healthcare workers (HCWs) in Malawi. Overall, higher hand hygiene practices were reported than observed among nurses and clinicians in all the World Health Organization's (WHO) five critical moments of hand hygiene. This calls on the need for a combination of infrastructure, consumables (e.g., soap) and theory driven behavior change interventions to influence adoption of the recommended hand hygiene behaviors. However, such interventions should not include demographic factors (i.e., age, profession and ward) as they have been proven not to influence hand hygiene performance.
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Affiliation(s)
- Monica Nzanga
- Department of Environmental Health, Malawi University of Business and Applied Sciences, Private Bag 303, Chichiri, Blantyre 3, Malawi
| | - Mindy Panulo
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Malawi University of Business and Applied Sciences, Private Bag 303, Chichiri, Blantyre 3, Malawi
| | - Tracy Morse
- Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Kondwani Chidziwisano
- Department of Environmental Health, Malawi University of Business and Applied Sciences, Private Bag 303, Chichiri, Blantyre 3, Malawi
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Malawi University of Business and Applied Sciences, Private Bag 303, Chichiri, Blantyre 3, Malawi
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Gupta P, Biswal M, Kaur R, Kaur K, Kaur H, Kaur M, Mahajan V, Puri GD, Guru RR, Kaushal V. Quantification of diurnal variation in “glove hygiene” compliance in COVID ICUs: an exploratory study. Am J Infect Control 2022; 51:372-375. [PMID: 35908730 PMCID: PMC9334865 DOI: 10.1016/j.ajic.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
Background Hand hygiene compliance (HHC) monitoring is almost always done in daytime. Documentation of HHC in health care workers (HCWs) is limited during odd hours and nighttime. The objective of the study was to determine diurnal variation in HHC in different categories of health care workers in tertiary care hospital in North India. Methods A prospective, observational study was conducted in 3 COVID-19 intensive care units (ICUs) with closed-circuit television (CCTV) cameras. Dedicated infection control nurses monitored HHC among various HCWs (doctors, nursing staff, technicians, hospital and sanitary attendants) during day and nighttime, in 20-minute durations. The difference in HHC by-professional category and for each WHO moment was assessed using χ² test and P value. Results A total of 705 opportunities were observed over a period of 7 days, with overall compliance of 53%. Day and nighttime compliance was recorded to be 60.7% and 42.1%, respectively (P < .001). HCC was highest amongst resident doctors with little diurnal variation. However, nurses and housekeeping staff exhibited significant diurnal variation. The compliance at “after” moments was much higher than “before” moments in all professional categories. Conclusion There was a significant decrease in compliance during nighttime, amongst all HCWs, with maximum variation exhibited by nursing staff. The present study underlines the importance of monitoring HHC at odd hours, to elicit a more accurate picture round the clock. Health care facilities monitoring compliance only during the daytime may substantially overestimate HHC.
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Affiliation(s)
- Parakriti Gupta
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
| | - Rupinder Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Kulbeer Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Harinder Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Manjinder Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Varun Mahajan
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - G D Puri
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Rashmi R Guru
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Vipin Kaushal
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
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Alsuliman T, Alasadi L, Alrstom A, Alabdallah G, Sneij J, Al Khalaf R, Alhalabi M. Protective Measures Practices Among Hospitals' Professionals Working in a Fragile Health System. Disaster Med Public Health Prep 2022; 17:e84. [PMID: 35179105 DOI: 10.1017/dmp.2021.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to assess the protective measures among health-care workers (HCWs) in a war-torn area during coronavirus disease 2019 (COVID-19) pandemic. METHODS An online cross-sectional questionnaire was administrated to HCWs in Syria between April 1 and May 21, 2020. The questions aimed to assess the HCWs' application of safety, hygiene, and necessary protection considerations while attending to suspected or proven COVID-19 cases. Unpaired t-test and 1-way analysis of variance (ANOVA) were used for statistical analysis. RESULTS Of the 290 participants included in the statistical analysis, 250 were medical doctors. Low scores of protective practices were noticed among the participants, as only 12% of doctors had a score above 6/15 points, and only 37.5% of nurses had a score of more than 4/12 points. Medical doctors who were not on the frontlines scored significantly higher than those who were on the frontlines (4.69 vs 3.80 points, respectively; P < 0.001). CONCLUSIONS More courses and training sessions should be implemented to improve the practice of protective measures among HCWs (frontliners in particular) in areas with fragile health systems, such as Syria, during the COVID-19 pandemic, especially those on the frontlines. Moreover, specific COVID-19 protection measures guidelines to low-income countries are needed.
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14
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Angurana SK, Chetal P, Mehta R, Suthar R, Sundaram V, Singh R, Kaur R, Kaur H, Biswal M, Kumar P, Jayashree M. Hand Hygiene Compliance in Pediatric Emergency of a Lower-Middle Income Country: A Quality Improvement Study. Front Pediatr 2022; 10:869462. [PMID: 35573959 PMCID: PMC9099088 DOI: 10.3389/fped.2022.869462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Prospective data on hand hygiene compliance in pediatric emergency department (PED) settings is limited. We studied the impact of quality improvement measures on the overall and health care personnel wise hand hygiene compliance rates in a busy PED. METHODS The baseline hand hygiene compliance rates were audited from May-July 2018. The quality improvement interventions included various structural changes to the environment, administrative changes, education and training. During the interventions, auditing was continued for 2 months (August - September 2018). Statistical Process control charts were created. RESULTS We observed a significant increase in overall compliance rates from 31.8 to 53.9% (p < 0.001). These improvements were observed in the children (29.6 to 46.4%, p < 0.001) as well as neonatal area (35.7% to 59.7, p < 0.001) of PED as well as amongst various health care personnel and in four out of the five moments of hand hygiene. CONCLUSION Hand hygiene compliance improved significantly in a busy PED of a lower middle-income country following quality improvement interventions. Such improvement was observed amongst all categories of health care personnel and different types of hand hygiene opportunities. This study demonstrates the feasibility and efficacy of simple quality improvement interventions in a challenging hospital environment.
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Affiliation(s)
- Suresh Kumar Angurana
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pooja Chetal
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Richa Mehta
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Renu Suthar
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Venkataseshan Sundaram
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ranjana Singh
- Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rupinder Kaur
- Department of Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Harinder Kaur
- Department of Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Manisha Biswal
- Department of Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Muralidharan Jayashree
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Soboksa NE, Negassa B, Kanno G, Ashuro Z, Gudeta D. Hand Hygiene Compliance and Associated Factors among Healthcare Workers in Ethiopia: A Systematic Review and Meta-Analysis. Adv Prev Med 2021; 2021:7235248. [PMID: 34950518 DOI: 10.1155/2021/7235248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Promoting hand hygiene compliance should be a priority for health authorities and all healthcare facilities at all levels. Therefore, this systematic review and meta-analysis aimed to provide a pooled estimate of hand hygiene compliance and associated factors among healthcare professionals in Ethiopia. Methods PubMed, Science Direct, EMBASE, the Google search engine, and Google Scholar were used to retrieve studies that were eligible for the study. The searches included all studies published in English prior to July 2021. Using a structured data extraction format, two authors independently extracted the required data. STATA Version 16 software has been used for statistical analysis. To measure the heterogeneity of the studies, the Cochrane Q-test statistics and I2 test were used. Because of the significant heterogeneity, a random-effects model was used. Results The pooled hand hygiene compliance among healthcare workers in Ethiopia was 38% (95% CI: 0.16-0.59). According to the study's subgroup analysis, Addis Ababa City administration health workers had the highest hand hygiene compliance, at 73% (95% CI: 0.50-0.96), while SNNP regional state had the lowest, at 9% (95% CI: 0.05-0.13). Presence of hand hygiene promotion (OR: 2.14, 95% CI: 1.04-3.24), towel/tissue paper availability (OR: 3.97, 95% CI: 2.09-5.86), having a positive attitude toward hand hygiene (OR: 1.79, 95% CI: 1.28-2.30), having good knowledge about hand hygiene (OR: 3.45, 95% CI: 1.26-5.64), and being trained for hand hygiene (OR:4.97, 95% CI:1.81-8.14) were significantly associated with hand hygiene compliance. Conclusion In this analysis, hand hygiene compliance among healthcare workers in Ethiopia was less than half. Providing hand hygiene promotion, towel/tissue paper presence, having a positive attitude toward hand hygiene, having good knowledge about hand hygiene, and being trained for hand hygiene were important variables for the increment of hand hygiene compliance.
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16
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Lotfinejad N, Peters A, Tartari E, Fankhauser-Rodriguez C, Pires D, Pittet D. Hand hygiene in health care: 20 years of ongoing advances and perspectives. Lancet Infect Dis 2021; 21:e209-e221. [PMID: 34331890 DOI: 10.1016/s1473-3099(21)00383-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 12/14/2022]
Abstract
Health-care-associated infections are the most prevalent adverse events of hospital care, posing a substantial threat to patient safety and burden on society. Hand hygiene with alcohol-based hand rub is the most effective preventive strategy to reduce health-care-associated infections. Over the past two decades, various interventions have been introduced and studied to improve hand hygiene compliance among health-care workers. The global implementation of the WHO multimodal hand hygiene improvement strategy and constant efforts to replace the use of soap and water with alcohol-based hand rub have led to a faster and more efficient hand cleaning method. These strategies have strongly contributed to the success of behaviour change and a subsequent decrease in health-care-associated infections and cross-transmission of multidrug-resistant organisms worldwide. The WHO multimodal behaviour change strategy requires a series of elements including system change as a prerequisite for behaviour, change, education, monitoring and performance feedback, reminders in the workplace, and an institutional safety climate. Successful adoption of the promotion strategy requires adaptation to available resources and sociocultural contexts. This Review focuses on the major advances and challenges in hand hygiene research and practices in the past 20 years and sets out various ways forward for improving this lifesaving action.
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Affiliation(s)
- Nasim Lotfinejad
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Alexandra Peters
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ermira Tartari
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Malta
| | | | - Daniela Pires
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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17
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Deshommes T, Nagel C, Tucker R, Dorcélus L, Gautier J, Koster MP, Lechner BE. A Quality Improvement Initiative to Increase Hand Hygiene Awareness and Compliance in a Neonatal Intensive Care Unit in Haiti. J Trop Pediatr 2021; 67:5864459. [PMID: 32594158 DOI: 10.1093/tropej/fmaa029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Healthcare-associated infections (HCAI) are major causes of morbidity, mortality, increased lengths of stay and are an economic burden on healthcare systems in resources-limited settings. This is especially true for neonates, who are more susceptible with underdeveloped immune systems. Hand hygiene (HH) is a key weapon against HCAI, yet globally, HH compliance remains substandard. This study sought to determine the compliance with HH among healthcare workers (HCWs) in a children's hospital neonatal intensive care unit (NICU) in Haiti. METHODS A HH educational intervention was performed in the NICU, including lectures and posters. Pre- and post-intervention HH data were collected on HCWs and parents using the World Health Organization '5 Moments for HH'. Data were analyzed using standard statistical analysis. RESULTS HH increased in all HCW roles but not in parents. Correct HH increased in all groups, including parents. HH was more likely to occur prior to patient contact than after patient contact. Correct HH was more likely to occur with alcohol-based hand rub than with soap and water. CONCLUSION This study demonstrates that an inexpensive and simple intervention can significantly increase HH compliance in a resource-limited NICU, which may lead to decreased rates of hospital-acquired sepsis. Parents, however, due to cultural norms as well as literacy and language barriers, need targeted educational interventions distinct from those that HCW benefit from.
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Affiliation(s)
- Theony Deshommes
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Christian Nagel
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Richard Tucker
- Department of Pediatrics, Division of Neonatology, Women and Infants Hospital, Providence, RI 02905, USA
| | - Lindsay Dorcélus
- Department of Pediatrics, Division of Neonatology, Hôpital Saint-Damien, Nos Petits-Frères et Sœurs, Tabarre, Haiti 6110
| | - Jacqueline Gautier
- Department of Pediatrics, Division of Neonatology, Hôpital Saint-Damien, Nos Petits-Frères et Sœurs, Tabarre, Haiti 6110
| | - Michael P Koster
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI 02903, USA.,Department of Pediatrics, Hasbro Children's Hospital, Providence, RI 02903, USA
| | - Beatrice E Lechner
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI 02903, USA.,Department of Pediatrics, Division of Neonatology, Women and Infants Hospital, Providence, RI 02905, USA
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Gedamu H, W/Giorgis T, Tesfa G, Tafere Y, Genet M. Hand washing practice among health care workers in Ethiopia: systemic review and meta-analysis, 2020. Heliyon 2021; 7:e06972. [PMID: 34027175 PMCID: PMC8129942 DOI: 10.1016/j.heliyon.2021.e06972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/12/2020] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Hand washing with soap and water is the single most weapon against infectious agents. Proper hand washing is not only reduces nosocomial infection, but also prevents the spread of current global concern Novel Corona viruses (COVID-19) and other viral illnesses like cold and flu. Therefore, the aim of this study is to assess hand washing practice among health care workers in Ethiopia. Methods In the current meta-analysis, the target variables search from different databases, like Google Scholar, African Journals OnLine, PubMed, and Scopus. All necessary data extracted by using a standardized data extraction format. Heterogeneity across the studies was evaluated using the I2 index and Cochran's Q test. A random effect model computes to estimate the pooled proportion of hand washing practice among health care workers. Results In this meta-analysis, we included fifteen observational studies summarize the proportional of hand washing practice among health care workers. In the current study, the pooled hand washing practices among Ethiopian was 57.87% (95% CI: 44.14–71.61). Subgroup analysis conduct to identifying the sources of heterogeneity. Conclusion The overall pooled proportion of hand washing practice among health care workers was low. Hand washing with water and soap is recommended at least for 20 s to prevent contagious disease like Corona viruses.
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Affiliation(s)
- Haileyesus Gedamu
- Adult Health Nursing Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Teshager W/Giorgis
- Adult Health Nursing Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getasew Tesfa
- Pediatric Nursing Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yilkal Tafere
- Public Health Department, Debremarkos University, Debremarkos, Ethiopia
| | - Minichil Genet
- Nursing Department, Bahir Dar Health Science College, Bahir Dar, Ethiopia
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Ashinyo ME, Dubik SD, Duti V, Amegah KE, Ashinyo A, Asare BA, Ackon AA, Akoriyea SK, Kuma-Aboagye P. Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study. PLoS One 2021; 16:e0248282. [PMID: 33690699 PMCID: PMC7943010 DOI: 10.1371/journal.pone.0248282] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/24/2021] [Indexed: 02/07/2023] Open
Abstract
Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.
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Affiliation(s)
- Mary Eyram Ashinyo
- Institutional Care Division, Ghana Health Service Headquarters, Accra, Ghana
- * E-mail:
| | - Stephen Dajaan Dubik
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Vida Duti
- IRC-Ghana, Cantonments, Accra, Ghana
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Saporito L, Graziano G, Mescolo F, Amodio E, Insinga V, Rinaudo G, Aleo A, Bonura C, Vitaliti M, Corsello G, Vitale F, Maida CM, Giuffrè M. Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program. Antimicrob Resist Infect Control 2021; 10:30. [PMID: 33541419 PMCID: PMC7863509 DOI: 10.1186/s13756-021-00902-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
Background Antimicrobial resistance in neonatal intensive care unit (NICU) patients is a threat, due to the frequent use of antimicrobial treatment and invasive devices in fragile babies. Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage has been in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB, and in particular of extended-spectrum β-lactamases-producing Klebsiella pneumoniae (ESBL-KP), was observed in “Civico” hospital NICU. Aim To assess the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU. Methods Rectal swabs were obtained monthly and processed to detect MDR-GNB using standard methods. MDR-GNB were characterized by pulsed-field gel electrophoresis (PFGE). Since November 2017 the following intervention measures were applied: (a) two-months intensification of sample collection; (b) stakeholders meetings; (c) improvement of prevention measures and antimicrobial policies. Findings During the intensified microbiological surveillance MDR-GNB and ESBL-KP were detected in rectal swabs (34.8%; 23.2%), nasal swabs (24.6%; 14.5%), oral swabs (14.5%; 5.4%), milk samples (32.1%; 17.9%), pacifiers swabs (30.8%; 17.9%) and from sub-intensive room surfaces. Thirteen ESBL-KP strains isolated from clinical and environmental samples showed identical PFGE patterns. The prevalence of MDR-GNB and ESBL-KP carriage significantly decreased in the year after intervention compared to the previous year (20.6% vs 62.2%; p < 0.001 and 11.1% vs 57.8%; p < 0.001). MDR-GNB were not detected at all for three months and ESBL-KP for five months. Multivariate analysis of the principal exposure variables showed that admission in the post-intervention period significantly reduced the risk of MDR-GNB carriage (adj-OR = 0.21, 95% CI = 0.076–0.629; p < 0.001). Conclusions MDR-GNB broadly circulate in NICU setting, they can colonize different body sites and spread through various vehicles. A coordinated strategy of multiple interventions with active cooperation between epidemiologists and clinicians in the NICU can effectively reduce their circulation and in particular the carriage of the most dangerous ESBL-KP strains.
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Affiliation(s)
- Laura Saporito
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Giorgio Graziano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Federica Mescolo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Vincenzo Insinga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Grazia Rinaudo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Aurora Aleo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Celestino Bonura
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Marcello Vitaliti
- Neonatology and Neonatal Intensive Care Unit, ARNAS Civico - Di Cristina - Benfratelli, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Assefa D, Melaku T, Bayisa B, Alemu S. Knowledge, Attitude and Self-Reported Performance and Challenges of Hand Hygiene Using Alcohol-Based Hand Sanitizers Among Healthcare Workers During COVID-19 Pandemic at a Tertiary Hospital: A Cross-Sectional Study. Infect Drug Resist 2021; 14:303-313. [PMID: 33542637 PMCID: PMC7853419 DOI: 10.2147/idr.s291690] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/19/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Understanding and consistent hand hygiene practice by alcohol-based hand sanitizer is a cardinal step to stay safe from the coronavirus disease (COVID-19) pandemic. This study aimed to assess the self-reported level of knowledge, attitude, practice, and challenges to practice hand hygiene by alcohol-based hand sanitizers among healthcare workers during the COVID-19 pandemic in Jimma Medical Center, Ethiopia. METHODS Between April and June 2020, a questionnaire-based descriptive cross-sectional study was conducted using 96 study participants. Data were analyzed using SPSS version 21 and described. RESULTS All of the study participants (96) were at the forefront of the fight against COVID-19. Most of the study participants were nurses (27) and pharmacists (21). Their mean age was 28.69±4.048 years. All of them were practicing different COVID-19 prevention methods. In this study, 95.8% of the respondents used alcohol-based hand sanitizers. The majority of the respondents were knowledgeable (93.8%), had a favorable attitude (74%), and good hand hygiene practices (76%) by alcohol-based hand sanitizers. However, 84.5% of the respondents were confronted with challenges during alcohol-based hand sanitizer use due to it is unavailable 66 (68.8%), expensive 50 (52.1%), forgetting 11 (11.5%), experiencing health-associated risks (skin irritation (28.1%), skin dryness (62.5%), ocular irritation (11.5%)), etc. CONCLUSION The majority of respondents had good knowledge, attitude, and practices of alcohol-based hand sanitizer. But there were some items of their evaluation with relatively low scores that revealed some room for improvements. Additionally, the respondents reported various challenges. Therefore, to achieve and sustain changes, the hand hygiene promotion strategic plan needs a great concern.
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Affiliation(s)
- Desta Assefa
- School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
| | - Tsegaye Melaku
- School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
| | - Bodena Bayisa
- School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
| | - Sintayehu Alemu
- School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
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Salcedo-Cifuentes M, Ordóñez-Hernández CA, Calvo-Soto AP. Cumplimiento de una estrategia de higiene de las manos en ambientes asistenciales. Investg Enferm Imagen Desarollo 2020. [DOI: 10.11144/javeriana.ie22.cehm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introducción: Si bien la higiene de las manos es la medida más importante en la mitigación del riesgo biológico en ambientes hospitalarios, evidencia científica muestra un escaso cumplimiento de las recomendaciones entre los trabajadores asistenciales. Objetivo: Evaluar el cumplimiento de cinco dimensiones que fortalecen la estrategia de higiene de las manos para la prevención del riesgo biológico en ambientes asistenciales. Método: Estudio observacional, de corte transversal, en cinco instituciones prestadoras de servicios de salud. Se aplicó estadística descriptiva. Con el Test de Medianas se evaluó si había diferencias significativas entre el grupo de profesionales por institución de salud, considerando significante una p ≤ 0,05. El análisis finalizó con un análisis discriminante. Resultados: La representatividad estuvo en las instituciones hospitalarias de primer nivel en las cuales el personal de enfermería, seguido por los médicos, tuvo un mejor cumplimiento del protocolo de lavado de manos. Este porcentaje se vio impactado por el menor cumplimiento de suministro de insumos e infraestructura. Hay una perfecta diferenciación entre los resultados del municipio de Cali con relación al de Caicedonia, en contraste con los de Popayán, Buga y Buenaventura. Conclusión: Se encontró un incumplimiento del protocolo de higiene de las manos, con una calificación inaceptable para los factores de insumos/infraestructura y técnica de higiene de las manos, respectivamente.
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Yehouenou CL, Dohou AM, Fiogbe AD, Esse M, Degbey C, Simon A, Dalleur O. Hand hygiene in surgery in Benin: opportunities and challenges. Antimicrob Resist Infect Control 2020; 9:85. [PMID: 32539867 PMCID: PMC7296752 DOI: 10.1186/s13756-020-00748-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 06/04/2020] [Indexed: 02/03/2023] Open
Abstract
Background Hand Hygiene (HH) has been described as the cornerstone and starting point in all infection control. Compliance to HH is a fundamental quality indicator. The aim of this study was to investigate the HH compliance among Health-care Workers (HCWs) in Benin surgical care units. Methods A multicenter prospective observational study was conducted for two months. The World Health Organization (WHO) Hand Hygiene Observation Tool was used in obstetric and gastrointestinal surgery through six public hospitals in Benin. HH compliance was calculated by dividing the number of times HH was performed by the total number of opportunities. HH technique and duration were also observed. Results A total of 1315 HH opportunities were identified during observation period. Overall, the compliance rate was 33.3% (438/1315), without significant difference between professional categories (nurses =34.2%; auxiliaries =32.7%; and physicians =32.4%; p = 0.705). However, compliance rates differed (p < 0.001) between obstetric (49.4%) and gastrointestinal surgery (24.3%). Generally, HCWs were more compliant after body fluid exposure (54.5%) and after touching patient (37.5%), but less before patient contact (25.9%) and after touching patient surroundings (29.1%). HCWs were more likely to use soap and water (72.1%) compared to the alcohol based hand rub solution (27.9%). For all of the WHO five moments, hand washing was the most preferred action. For instance, hand rub only was observed 3.9% after body fluid exposure and 16.3% before aseptic action compared to hand washing at 50.6 and 16.7% respectively. Duration of HH performance was not correctly adhered to 94% of alcohol hand rub cases (mean duration 9 ± 6 s instead of 20 to 30 s) and 99.5% of hand washing cases (10 ± 7 s instead of the recommended 40 to 60 s). Of the 432 HCWs observed, 77.3% followed HH prerequisites (i.e. no artificial fingernails, no jewellery). We also noted a lack of permanent hand hygiene infrastructures such as sink, soap, towels and clean water. Conclusion Compliance in surgery was found to be low in Benin hospitals. They missed two opportunities out of three to apply HH and when HH was applied, technique and duration were not appropriate. HH practices should be a priority to improve patient safety in Benin.
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Affiliation(s)
- Carine Laurence Yehouenou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain UCLouvain, Brussels, Belgium. .,Laboratoire de Référence des Mycobactéries (LRM), Cotonou, Benin. .,Faculte des Sciences de la Sante (FSS), Université d'Abomey Calavi (UAC), Cotonou, Benin, O3BP1326.
| | - Angèle Modupe Dohou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain UCLouvain, Brussels, Belgium.,Faculte des Sciences de la Sante (FSS), Université d'Abomey Calavi (UAC), Cotonou, Benin, O3BP1326
| | - Ariane Dessièdé Fiogbe
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain UCLouvain, Brussels, Belgium.,Faculte des Sciences de la Sante (FSS), Université d'Abomey Calavi (UAC), Cotonou, Benin, O3BP1326
| | - Marius Esse
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou, Benin
| | - Cyriaque Degbey
- Institut Régional de Santé Publique Comlan Alfred Quenum (IRSP), Ouidah, Benin.,Clinique Universitaire d'Hygiène Hospitalière, Centre National Hospitalo-universitaire Hubert Koutoukou Maga, Cotonou, Benin
| | - Anne Simon
- Pole de microbiologie, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain UCLouvain, Brussels, Belgium.,Microbiologie, Cliniques universitaires Saint-Luc, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Olivia Dalleur
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain UCLouvain, Brussels, Belgium.,Pharmacy, Cliniques universitaires Saint-Luc, Université catholique de Louvain, UCLouvain, Brussels, Belgium
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Karabay M, Kaya G, Hafizoglu T, Karabay O. Effect of camera monitoring and feedback along with training on hospital infection rate in a neonatal intensive care unit. Ann Clin Microbiol Antimicrob 2019; 18:35. [PMID: 31722715 PMCID: PMC6852772 DOI: 10.1186/s12941-019-0332-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background In terms of pediatric healthcare-associated infections (HAI), neonatal intensive care units (NICU) constitute the greatest risk. Contacting a health care personnel, either directly or indirectly, elevates NICU occurrence rate and risks other infants in the same unit. In this study, it is aimed to retrospectively analyze the effect of the training along with camera monitoring and feedback (CMAF) to control the infection following a small outbreak. Methods ESBL producing Klebsiella pneumoniae was detected on three infants in May 2014 at the isolation room of Sakarya University Hospital NICU. Precautions were taken to prevent further spread of the infection. The infected infants were isolated and the decolonization process was initiated. For this aspect, health care workers (HCWs) in NICU were trained for infection control measures. An infection control committee has monitored the HCWs. Before monitoring, an approval was obtained from the hospital management and HCWs were informed about the CMAF, who were then periodically updated. On a weekly basis, NICU workers were provided with the feedbacks. Epidemic period and post-epidemic control period (June–July–August 2014) were evaluated and p value < 0.05 was considered statistically significant. Results Healthcare-associated infection (HAI) density was 9.59% before the onset of the CMAF, whereas it was detected as 2.24% during the CMAF period (p < 0.05). Following the precautions, HAI and HAI density rates have reduced to 76.6% and 74.85%, respectively. Moreover, hand hygiene compliance of health care workers was found 49.0% before the outbreak, whereas this rate has elevated to 62.7% after CMAF. Conclusions Healthcare workers should be monitored in order to increase their compliance for infection control measures. Here, we emphasized that that CMAF of health workers may contribute reducing the HAI rate in the NICU.
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Affiliation(s)
- Meltem Karabay
- Department of Pediatrics, Newborn Unit, Sakarya University Faculty of Medicine, Sakarya, 54100, Türkiye.
| | - Gulsum Kaya
- Member of Infection Control Committee, Sakarya University Faculty of Medicine, Adnan Menderes Bulvari, Sakarya, Turkey
| | - Taner Hafizoglu
- Department of Pediatrics, Newborn Unit, Sakarya University Faculty of Medicine, Sakarya, 54100, Türkiye
| | - Oguz Karabay
- Member of Infection Control Committee, Sakarya University Faculty of Medicine, Adnan Menderes Bulvari, Sakarya, Turkey
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Biswal M, Angrup A, Rajpoot S, Kaur R, Kaur K, Kaur H, Kaur H, Dhaliwal N, Arora P, Gupta AK. Hand hygiene compliance of patients' family members in India: importance of educating the unofficial 'fourth category' of healthcare personnel. J Hosp Infect 2020; 104:425-9. [PMID: 31542457 DOI: 10.1016/j.jhin.2019.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION 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 World Health Organization (WHO) 'five moments for hand hygiene'. This study analysed the impact of decade-long awareness campaigns on the hand hygiene compliance (HHC) by our patients' carers. METHODS Trained infection control nurses observed the HHC at each of the five moments for patients' attendants in different hospital settings from January 2014 to December 2018. Compliance was calculated as percentage of events divided by total opportunities. FINDINGS A total of 7302 opportunities were observed with an overall compliance of 46.1% (35.5% in 2014 to 48.2% in 2018, P < 0.0001). Compliance at WHO moments 1, 2, 3, 4, and 5 was 51.0%, 47.4%, 67.6%, 48.8%, and 24.3% respectively. Among family members, mothers of newborns had a much higher HHC (77%) than others (44.5%) (P < 0.0001). Also, the compliance was higher in medical versus surgical wards and in paediatric wards versus adult wards (P < 0.0001 in both). CONCLUSION This is the first study on family members' HHC in a hospital setting in a low- and middle-income country. The study shows that family members, once trained, exhibit fairly good HHC while caring for their patients, especially mothers of newborns. 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.
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Bushuven S, Dietz A, Bushuven S, Dettenkofer M, Langer T. Interprofessional perceptions and emotional impact of multidrug-resistant organisms: A qualitative study. Am J Infect Control 2019; 47:876-82. [PMID: 30850246 DOI: 10.1016/j.ajic.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hospital-acquired infections caused by multidrug-resistant organisms (MDROs) are a threat to patient safety and hospital economy. Training in hygiene precautions is known to limit MDRO spread and patient morbidity. As infection prevention is a collaborative task, we developed an interprofessional educational intervention, including a reflective unit about MDRO. This article reports on the perceptions of professionals for MDRO management. METHODS In 2017, we conducted 8 trainings, including facilitated group discussions focusing on the question how participants think others experience MDRO. Results were analyzed using a socio-constructivist qualitative approach. RESULTS A total of 51 health care workers from 13 professions and 5 hospitals participated, generating 366 items for coding. Three main themes could be identified: (1) significant barriers in educating clinicians and informing lay persons, (2) emotional reactions-especially anxiety and anger-from the perspective of lay persons and professionals evoked by MDRO, and (3) perceived economic burden. CONCLUSIONS MDROs generate psychosocial side effects with an impact on health care management and on professional-patient relationships and interprofessional relationships. Specifically, emotions evoked by insufficient information and transparency play a major role. Therefore, hygiene trainings must not be limited to basic skills. In addition, they should be comprised of communication and educational techniques and evoke attentiveness for emotional stress.
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Abstract
Objective: Improving the compliance to hand hygiene in healthcare providers is important to reduce healthcare-associated infections. This study aimed to compare the compliance rate before and after the improvement of compliance to hand hygiene. Methods: In this study 270 of the 348 medical staff working in a 61-bed private hospital was observed. The informed observation was performed by the infection control committee in the entire hospital using “Five Moments for Hand Hygiene” for a period of one year. After the first six months, an improvement study was conducted together with the hospital’s quality department using the plan-do-check-act cycle. The study was conducted in a private hospital in Istanbul/Turkey; Kadıkoy Florence Nightingale Hospital in 2014. Results: In the first six months of the year, 153 actions were observed at 316 proper situations. The compliance rate was 35%, 54% and 64% for the physicians, nurses and, other healthcare staff, respectively. The overall compliance rate was 48%. One hundred eighty-three actions were observed for 306 situations after the improvement and education studies. The compliance rate was 29%, 72% and 86%. The overall mean compliance rate was 60%. Conclusion: The promotion of hand hygiene requires the cooperation of the hospital administrators, infection control committee, and quality departments for better hand hygiene practices among the healthcare providers.
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Affiliation(s)
- Aslihan Demirel
- Aslihan Demirel, Department of Infectious Diseases, Istanbul Kadikoy Florence Nightingale Hospital, Istanbul, Turkey
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Manzo BF, Mariano DR, Ferreira FMC, Matozinhos FP, Simão DADS, Costa ACL, Corrêa ADR. Knowledge and behavior of professionals about bundled strategies of central venous catheter. Rev Bras Enferm 2019; 72:50-56. [PMID: 30916267 DOI: 10.1590/0034-7167-2018-0164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/13/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the factors that influence the knowledge and behavior of professionals of neonatal and pediatric units about bundled strategies of insertion of central venous catheter. METHOD This is a cross-sectional study, conducted in one neonatal and one pediatric intensive care units in a public hospital in Belo Horizonte, Brazil, from April to July, 2016. The sample consisted of 255 professionals who answered a structured instrument. Descriptive and comparative analyses were made using the SPSS software. RESULTS The category nursing professional (p = 0.010), working hours of 12×36 scale (p < 0.001), training as a form of acquiring knowledge (p < 0.001) and participation in training programs (p < 0.001) are associated to greater knowledge about the bundle. Regarding behavior, no significant associations were observed. CONCLUSION The study showed that there are factors that influence the knowledge about bundled strategies of insertion of central venous catheter, reflecting the need to consider these practices for making more effective educational practices in health care.
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Affiliation(s)
- Bruna Figueiredo Manzo
- Universidade Federal de Minas Gerais, School of Nursing. Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | | | - Allana Dos Reis Corrêa
- Universidade Federal de Minas Gerais, School of Nursing. Belo Horizonte, Minas Gerais, Brazil
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Halim MM, Eyada IK, Tongun RM. Prevalence of multidrug drug resistant organisms and hand hygiene compliance in surgical NICU in Cairo University Specialized Pediatric Hospital. Egyptian Pediatric Association Gazette 2018; 66:103-11. [DOI: 10.1016/j.epag.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Karaoglu MK, Akin S. Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge: A Nonrandomized Quasi-Experimental Design. J Contin Educ Nurs 2018; 49:360-371. [PMID: 30053307 DOI: 10.3928/00220124-20180718-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/12/2018] [Indexed: 11/20/2022]
Abstract
Nurses undertake important responsibilities in patient care and the prevention of hospital-acquired infections. However, adherence to hand hygiene practices among nurses has been reported to be low. This study aims to evaluate the effectiveness of hygienic hand washing training on hand washing practices and knowledge. The study design was a nonrandomized, quasi-experimental study, with pretest-posttest for one group. Pre- and postobservations were also conducted using an observation form on any 5 workdays to evaluate the effectiveness of hygienic hand washing training on hand washing practices. The study was conducted with 63 nurses working at a hospital in Istanbul. Hand Hygiene Knowledge Form scores after hygienic hand washing training were higher than the pretraining scores. The number of the nurses' hand hygiene actions after hand hygiene training increased significantly compared with that before training. The results indicate that training in proper hand washing techniques and hygienic hand washing practices positively affects the knowledge level of nurses and their hand washing behavior. J Contin Educ Nurs. 2018;49(8):360-371.
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Laskar AM, R D, Bhat P, Pottakkat B, Narayan S, Sastry AS, Sneha R. A multimodal intervention to improve hand hygiene compliance in a tertiary care center. Am J Infect Control 2018; 46:775-780. [PMID: 29753498 DOI: 10.1016/j.ajic.2017.12.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are a major threat to patient safety worldwide. HAIs are mainly transmitted via the hands of healthcare workers (HCWs), and HCW compliance with hand hygiene (HH) practices is reportedly low. Therefore, multimodal interventions are needed to develop effective HH improvement strategies. In this study, we assessed the effect of multimodal interventions on improvement of HH compliance. METHODS This study was conducted in 2 intensive care units from August 2016 to October 2016. It encompassed 3 phases: pre-intervention (20 days), intervention (1 month), and post-intervention (20 days). A total of 53 HCWs, including physicians, nurses, and housekeeping staff, were included in the HH audit. The audit was analyzed by direct observation and by a completed knowledge, attitude, and practice (KAP) questionnaire. RESULTS A total of 6350 HH opportunities were recorded; the results were 34.7%, 35%, and 69.7% for hand hygiene complete adherence rate (HHCAR), hand hygiene partial adherence rate (HHPAR), and hand hygiene adherence rate (HHAR), respectively. The HHCAR in the pre-intervention and post-intervention phases were 3% and 70.1%, respectively. HHCAR was highest among nurses (3.6% in the pre-intervention phase and 80.7% in the post-intervention phase). Other findings were that senior physicians had better HH compliance than junior physicians; in the pre-intervention phase, the HHCAR was better in the evening (4.8%); in the post-intervention phase, the HHCAR was better in the morning (72.1%); women had a higher HHCAR than men; and in the pre-intervention phase, good compliance was seen with Moments 2 and 3 of the World Health Organization's (WHO) Five Moments for Hand Hygiene, whereas in the post-intervention phase, good compliance was seen with Moments 3, 4, and 5. Questionnaire-based data were also analyzed to assess KAP of HH. We found that only 55%-82% of HCWs were aware of the WHO's Five Moments for Hand Hygiene. In the post-intervention phase, we observed a significant improvement in KAP of the study group. CONCLUSION Significant improvement in HH compliance can be achieved through a systematic, multidimensional intervention involving all types of HCWs.
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Awoke N, Geda B, Arba A, Tekalign T, Paulos K. Nurses Practice of Hand Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational Study. Nurs Res Pract 2018; 2018:2654947. [PMID: 29850239 DOI: 10.1155/2018/2654947] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background Nurses, who are the majority, can contaminate their hands with different types of microorganism during "clean" activities (e.g., lifting a patient; taking a patient's pulse, blood pressure, or oral temperature; or touching a patient's hand, shoulder, or groin). Yet good hand hygiene, the simple task of cleaning hands at the right time and in the right way, can reduce HCAIs that are transmitted by healthcare workers' hands. Method Observational study conducted among nurses by observational tool which was adopted from WHO observational tool. And finally compliance was calculated as a percentage (i.e., compliance% = (observed hand hygiene action (HHA) ÷ hand hygiene opportunity (O)) × 100). The data were first coded, entered, and cleaned using EpiData statistical software version 3.1 and then exported into SPSS statistical software version 22 for analysis. Data were presented using descriptive statistics. Result A total of 110 study participants were observed who gave a response rate of 94.8%. Total of 3902 opportunities and 732 hand hygiene actions were observed with overall compliance of 18.7%. The highest 22.9% hand hygiene practice was observed "before clean∖aseptic procedure." Highest 19.6% compliance was recorded at night shift and 22.7% in ICU ward of the hospital. Alcohol based hand rub was a major means of method used to clean hands. Conclusion and Recommendation Observed practice of hand hygiene was poor. Lack of training, conveniently located sink, hand washing agents, and lack of time were major reasons for not practicing hand hygiene. Successful promotion of hand hygiene through instituting system change (e.g., making hand hygiene products available at the point of care) should be considered.
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Belela-Anacleto ASC, Kusahara DM, Peterlini MAS, Pedreira MLG. Hand hygiene compliance and behavioural determinants in a paediatric intensive care unit: An observational study. Aust Crit Care 2018; 32:21-27. [PMID: 29580966 DOI: 10.1016/j.aucc.2018.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Hand hygiene is considered the single most effective means of reducing healthcare-associated infections, but improving and sustaining hand hygiene compliance remains a great challenge. OBJECTIVES To compare hand hygiene compliance before and after interventions to promote adherence in a paediatric intensive care unit (PICU) and to identify predictors of intention to perform the behaviour "hand hygiene during patient care in the PICU". METHODS A before and after study was conducted in three phases. Based on the World Health Organization guideline for hand hygiene compliance monitoring, 1261 hand hygiene opportunities were directly observed during routine patient care by two observers simultaneously, in a nine-bed PICU in Brazil, before and after infrastructure and educational interventions. To identify predictors of healthcare professionals' intention to perform the behaviour hand hygiene during patient care, a data collection instrument was designed based on the Theory of Planned Behaviour. Statistical analyses were undertaken using Chi-square test or the Fisher's exact test and regression analysis. A significance level of 5% (p < 0.05) was applied to all analyses. RESULTS The hand hygiene compliance rate increased significantly from 27.3% in the "pre-intervention phase" to 33.1% in "phase 1-post-intervention," to 37.0% in "phase 2-post-intervention" (p = .010). Perceived social pressure (p = .026) was a determinant factor of intention to perform the behaviour. CONCLUSIONS Hand hygiene compliance raised significantly after infrastructure, educational, and performance feedback interventions. However, despite the significant effect of the implemented interventions, the overall hand hygiene compliance rate was low. Perceived social pressure characterised a determinant factor of intention to perform the behaviour "hand hygiene during patient care in the PICU", reinforcing the need for behaviour determinants analysis when designing promotional interventions.
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Affiliation(s)
- Aline S C Belela-Anacleto
- Pediatric Nursing Department, Paulista Nursing School, Federal University of São Paulo, Napoleão de Barros Street, 754. Vila Clementino, São Paulo, 04024-002, Office 113, Brazil.
| | - Denise M Kusahara
- Pediatric Nursing Department, Paulista Nursing School, Federal University of São Paulo, Napoleão de Barros Street, 754. Vila Clementino, São Paulo, 04024-002, Office 113, Brazil.
| | - Maria Angélica S Peterlini
- Pediatric Nursing Department, Paulista Nursing School, Federal University of São Paulo, Napoleão de Barros Street, 754. Vila Clementino, São Paulo, 04024-002, Office 113, Brazil.
| | - Mavilde L G Pedreira
- Pediatric Nursing Department, Paulista Nursing School, Federal University of São Paulo, Napoleão de Barros Street, 754. Vila Clementino, São Paulo, 04024-002, Office 113, Brazil.
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Suner A, Oruc OE, Buke C, Ozkaya HD, Kitapcioglu G. Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods. BMC Med Inform Decis Mak 2017; 17:129. [PMID: 28859640 PMCID: PMC5580304 DOI: 10.1186/s12911-017-0528-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/18/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. METHODS Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). RESULTS A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in İzmir, Turkey. The mean age of the participants was 49.73 ± 8.46, and the mean experience year of the participants in their fields was 17.67 ± 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. CONCLUSION In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.
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Affiliation(s)
- Aslı Suner
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
| | - Ozlem Ege Oruc
- Department of Statistics, Faculty of Science, Dokuz Eylul University, İzmir, Turkey
| | - Cagri Buke
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
- Current address: Department of Infectious Diseases, Yeditepe University Hospital, Yeditepe University, İstanbul, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases, Cigli Regional Education Hospital, İzmir, Turkey
| | - Gul Kitapcioglu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
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Parga JJ, Valadez M, Chang RKR, Sarin-Gulian A, Holdbrooks H, Sklansky MS. Handshake-free zone in a neonatal intensive care unit: Initial feasibility study. Am J Infect Control 2017; 45:787-792. [PMID: 28320565 DOI: 10.1016/j.ajic.2017.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND The handshake represents a social custom with special importance in health care settings. However, handshakes can transmit disease and compliance with hand hygiene protocols averages <50%. We hypothesized that a handshake-free zone (HFZ) could be established within our neonatal intensive care unit (NICU) and would be well-received by patient families and their health care providers (HCPs). METHODS We established an HFZ and conducted a prospective cohort study in the NICU at 2 UCLA Medical Centers. Data collection tools included questionnaires for NICU families and their HCPs. RESULTS Handshake greetings occurred more frequently before than during the HFZ, as reported by HCPs (P = .0002) and patient families (P = .05). Before the HFZ, physicians were more likely than nurses to shake hands with patient families (P = .001), and believe the handshake was extremely important (P = .002); during the HFZ physicians' behaviors and attitudes shifted toward those of the nurses. All patient families and 66% of HCPs believed the NICU should consider establishing an HFZ. CONCLUSIONS The HFZ decreased the frequency of handshakes within the NICU. The influence of the HFZ on HCP behavior and attitudes varied with gender and profession. Patient families and most HCPs supported the implementation of an HFZ.
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Affiliation(s)
- Joanna J Parga
- UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Maria Valadez
- UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Ruey-Kang R Chang
- Department of Pediatrics, Harbor-University of California, Los Angeles, Torrance, CA
| | - Anahit Sarin-Gulian
- UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Heaven Holdbrooks
- UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Mark S Sklansky
- UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
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Sastry AS, R D, Bhat P. Impact of a hand hygiene audit on hand hygiene compliance in a tertiary care public sector teaching hospital in South India. Am J Infect Control 2017; 45:498-501. [PMID: 28131421 DOI: 10.1016/j.ajic.2016.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hand hygiene (HH) practice is considered the most simple, cost-effective, and efficient way to prevent device-associated infections. Continuous auditing plays a vital role in the conversion of HH knowledge into practice. METHODS An HH audit was carried out October 2015-September 2016 in 18 locations for a total of 1,080 observation periods and 64,800 minutes of observation. HH complete adherence rate (HHCAR) and HH partial adherence rate were analyzed. RESULTS The HHCAR, HH partial adherence rate, and nonadherence rate were 45.5%, 21.17%, and 33.3%, respectively. There was gradual statistically significant increase in monthly HHCAR during the study period from 37.5%-51.7% (P = .001). HHCAR was found to be highest among nurses (58.9%) followed by other staff (46.7%) and doctors (46.6%). World Health Organization Moments 3 and 4 had statistically significant compliance (78.5% and 71.8%, respectively; P < .001) compared with Moments 1, 2, and 5. As the HHCAR increases there is statistically significant decrease in device-associated infection rate from 10.6-3.9 per 1,000 device days (P = .042). CONCLUSIONS HH audit has a significant influence on HH compliance. More emphasis needs to be given on compliance with HH practice by doctors and with the World Health Organization "before" Moments, especially. HH audits should be a part of the infection control manual of every hospital.
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Sánchez-Carrillo LA, Rodríguez-López JM, Galarza-Delgado DÁ, Baena-Trejo L, Padilla-Orozco M, Mendoza-Flores L, Camacho-Ortiz A. Enhancement of hand hygiene compliance among health care workers from a hemodialysis unit using video-monitoring feedback. Am J Infect Control 2016; 44:868-72. [PMID: 27068027 DOI: 10.1016/j.ajic.2016.01.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The importance of hand hygiene in the prevention of health care-associated infection is well known. Experience with hand hygiene compliance (HHC) evaluation in hemodialysis units is scarce. METHODS This study was a 3-phase, prospective longitudinal intervention study during a 5-month period in a 13-bed hemodialysis unit at a university hospital in Northern Mexico. The unit performs an average of 1,150 hemodialysis procedures per month. Compliance was evaluated by a direct observer and a video assisted observer. Feedback was given to health care workers in the form of educational sessions and confidential reports and video analysis of compliance and noncompliance. RESULTS A total of 5,402 hand hygiene opportunities were registered; 5,201 during 7,820 minutes of video footage and 201 by direct observation during 1,180 minutes. Lower compliance during the baseline evaluation was observed by video monitoring compared with direct observation (P <0.05). Discrepancy between both methods was 29.2% (0.4%-59.8%); the average improvement in compliance during the study was 30.6% (range, 7.3%-75.5%). Global and Individual results for each subject revealed a statistically significant Improvement in the majority. Noncompliance according to WHO's 5 Moments for HH was greater for moment 5 (30.1%). We estimated that a health care worker in a hemodialysis unit could take 22-44.3% of working hours for proper hand hygiene compliance. CONCLUSIONS Video-assisted monitoring of hand hygiene is an excellent method for the evaluation of HHC in a hemodialysis unit; enhanced HHC can be achieved through a feedback program to the hemodialysis staff that includes video examples and confidential reports.
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Affiliation(s)
- Laura Arelí Sánchez-Carrillo
- Coordinación de Epidemiología, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico
| | - Juan Manuel Rodríguez-López
- Coordinación de Epidemiología, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico
| | | | - Laura Baena-Trejo
- Departamento de Medicina Interna, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico
| | - Magaly Padilla-Orozco
- Coordinación de Epidemiología, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico
| | - Lidia Mendoza-Flores
- Coordinación de Epidemiología, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico
| | - Adrián Camacho-Ortiz
- Coordinación de Epidemiología, Hospital Universitario "Dr. José Eleuterio González," Monterrey, Nuevo León, Mexico.
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Teker B, Ogutlu A, Gozdas HT, Ruayercan S, Hacialioglu G, Karabay O. Factors Affecting Hand Hygiene Adherence at a Private Hospital in Turkey. Eurasian J Med 2015; 47:208-12. [PMID: 26644771 DOI: 10.5152/eurasianjmed.2015.78] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Nosocomial infections are the main problems rising morbidity and mortality in health care settings. Hand hygiene is the most effective method for preventing these infections. In this study, we aimed to investigate the factors related with hand hygiene adherence at a private hospital in Turkey. MATERIALS AND METHODS This study was conducted between March and June 2010 at a private hospital in Turkey. During the observation period, employees were informed about training, then posters and images were hanged in specific places of the hospital. After the initial observation, training on nosocomial infections and hand hygiene was provided to the hospital staff in March 2010. Contacts were classified according to occupational groups and whether invasive or not. These observations were evaluated in terms of compatibility with hand hygiene guidelines. RESULTS Hand hygiene adherence rate of trained doctors was higher than untrained ones before patient contact and after environment contact [48% (35/73) versus 82% (92/113) p<0.05 and 23% (5/22) versus 76% (37/49) p<0.05 respectively]. Hand hygiene adherence rate of trained nurses was higher than untrained ones before patient contact [63% (50/79) versus 76% (37/49) p<0.05]. Hand hygiene adherence rate of trained assistant health personnel was higher than untrained ones before asepsis [20% (2/10) versus 73% (16/22) p<0.05]. In addition, it was seen that hand antiseptics were used when hand washing was not possible. CONCLUSION The increase at the rate of hand washing after training reveals the importance of feedback of the observations, as well as the training. One of the most important ways of preventing nosocomial infections is hand hygiene training that should be continued with feedbacks.
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Affiliation(s)
- Bahri Teker
- Infection Control Committee, Private Nisa Hospital, Istanbul, Turkey
| | - Aziz Ogutlu
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Hasan Tahsin Gozdas
- Department of Infectious Diseases and Clinical Microbiology, Dr. Münif Islamoglu Kastamonu State Hospital, Kastamonu, Turkey
| | - Saliha Ruayercan
- Infection Control Committee, Private Nisa Hospital, Istanbul, Turkey
| | | | - Oguz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
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