DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20194494

Assessment of hand hygiene practices among health care providers in a government tertiary care hospital

Richa Semwal, Shiv Kumar Yadav, A. R. Piyush, Bhola Nath

Abstract


Background: Hand hygiene practices either by hand rub by disinfectant or hand washing by soap and water are very important for preventing Health care-associated infections (HCAIs). WHO have devised guidelines for hand rub and hand wash and advocated “My five moments for hand hygiene” as the approach for appropriate performance, teaching and evaluation of hand hygiene. The objective of this study is to observe hand hygiene practices, among health care providers in a tertiary care govt. hospital and document facilities available at the point of patient care for hand hygiene practices.

Methods: A cross sectional observation study was conducted  in 8 departments of a Government Tertiary care Hospital for observation of hand hygiene practices as Per WHO Guideline on “5 Moment of Care”. Total of 600 observations were made and one Health care provider was observed once at a point of time. Data Entry was done in MS excel and was analysed in Open Epi software.

Results: Among 600 moments observed, 354 (59%) moments were those where hand hygiene practices were missed by HCPs. Among various HCPs 63% Doctors, 62% Nurses, 52% Medical students and 59% nursing students missed the hand hygiene practices. Lack of antimicrobial soap, alcohol based agents, sterile towel and hand drier were perceived barriers for hand hygiene Practices.

Conclusions: There lies a huge gap in practice of hand hygiene among all cadres of health care providers. The study is able to identify the lack of infrastructure which can be improved to promote hand hygiene in wards. 


Keywords


Hand hygiene, Perceived barriers, Health care providers, Health care-associated infections

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References


World Health Organisation. WHO guidelines on hand hygiene in health care. Geneva, Switzerland: WHO Press; 2009.

Zaidi AK1, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries. Lancet. 2005;365:1175–88.

Metintas S, Akgun Y, Durmaz G, Kalyoncu C. Prevalence and characteristics of nosocomial infections in a Turkish university hospital. Ame J Infec Control. 2004;32(7):409-13.

de Almeida e Borges LF, Rocha LA, Nunes MJ, GontijoFilho PP. Low compliance to handwashing program and high nosocomial infection in a brazilian hospital. Interdisciplinary Perspectives Infect Dis. 2012;2012:5.

Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000;356(9238):1307-12.

Mahfouz A, Al-Zaydani I, Abdelaziz A, El-Gamal M, Assiri A. Changes in hand hygiene compliance after a multimodal intervention among health-care workers from intensive care units in Southwestern Saudi Arabia. J Epidemiol Global Health. 2014;4(4):315-21.

Boyce J, Pittet D. Guideline for Hand Hygiene in Health‐Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol. 2002;23(S12):S3-40.

Larson E. A causal link between handwashing and risk of infection? Examination of the evidence. Infec Control Hospital Epidemiol. 1988;9:28–36.

Larson EL. Skin hygiene and infection prevention: more of the same or different approaches? Clin Infec Dis. 1999;29:1287–94.

Mathai E, Allegranzi B, Kilpatrick C, Pittet D. Prevention and control of health care-associated infections through improved hand hygiene. Indian J Med Microb. 2010;28:100–6.

Rupp ME, Fitzgerald T, Puumala S, Anderson JR, Craig R, Iwen PC, et al. Prospective, controlled,cross-over trial of alcohol-based hand gel in critical care units. Infect Control Hosp Epidemiol. 2008;29:8–15.

Kohli E, Ptak J, Smith R, Taylor E, Talbot EA, Kirkland KB. Variability in the Hawthorne effect withregard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol. 2009;30:222–5.

Stewardson A, Pittet D. Quicker, easier, and cheaper. The promise of automated hand hygienemonitoring?. Infect Control Hosp Epidemiol. 2011;32:1029–31.

Randle J, Arthur A, Vaughan N. Twenty-four-hour observational study of hospital hand hygiene compliance. J Hosp Infect. 2010;76:252–5.

Chavali S, Menon V, Shukl U. Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian J Crit Care Med. 2014;18(10):689–93.

Marra AR, Moura DF, Paes AT, dos Santos OF, Edmond MB. Measuring rates of hand hygiene adherence in the intensive care setting: A comparative study of direct observation, product usage, and electronic counting devices. Infect Control Hosp Epidemiol. 2010;31:796–801.

Heczko PB, Kleszcz P. Handwashing practices in Polish hospitals: results of a survey conducted by polish society of hospital infection. J Hosp Infect. 2001;48(SA):S47–9.