Journal of Patient Safety & Infection Control
Original ArticlePromotion of Successful Hand Hygiene practices in the Intensive Care Units of a Tertiary Care Hospital
Introduction
Control of nosocomial infections is a major health concern in a hospital setting. Colonization of healthcare workers’ (HCWs’) hands with Staphylococcus aureus has been described to range between 10.5% and 78.3%.1, 2 Similarly, colonization rates with Gram-negative bacteria ranged from 21% to 86.1%, the highest rate being found in the intensive care unit (ICU) setting.3 Hand hygiene is considered as the most important tool of infection control in the hospital setting. However, HCWs’ adherence to recommended hand hygiene practices is unacceptably low. Hand hygiene promotion requires a complex approach which should consider personal factors affecting health workers’ attitudes. It is also important to know the hand hygiene compliance in one's facility, and to select and implement effective interventions accordingly. The current study was carried out to find the hand washing compliance rate of HCWs in the ICU of our hospital and the factors associated with noncompliance, and to educate and sensitize the HCW for hand hygiene practices. A series of hand hygiene education was carried out, and the impact of a task-orientated hand hygiene education and intervention program was estimated.
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Material And Methods
This prospective study was conducted over a period of six months in the ICUs of the GB Pant Institute of Postgraduate Medical Education and Research, which is a tertiary care hospital. One hundred and six nursing staff posted in postoperative ward of the hospital were included in the study. The study was carried out in 3 phases. Phase 1 consisted of the evaluation of HCW's knowledge, beliefs, and perceptions toward hand hygiene using questionnaire issued by WHO and observation sessions.
Results
Of the 110 questionnaires distributed to the nurses, 106 were returned and included in the analysis. 76% were staff nurses and 24% were nursing sisters. The staff nurse had experience of 0–5 years and nursing sisters had work experience of 6 years and more. 92 (86.8%) of the respondents believed that the main route of cross-transmission of potentially harmful germs between the patients occurred through hands of HCWs. There was no significant difference of hand hygiene behavior and knowledge
Discussion
Healthcare-acquired infections (HAIs) are almost completely preventable, yet HAIs are responsible for a number of deaths. In addition to mortality, HAIs put a huge burden on hospitals. Most commonly used method to check hand hygiene compliance is by direct observation. According to the World Health Organization (WHO) guidelines, the observation is the “gold standard” for measuring hand hygiene adherence.4 It is the only way to directly measure the HCWs’ adherence to hand hygiene guidelines.4
Conflicts of interest
The authors have none to declare.
References (10)
Persistant carriage of gram-negative bacteria on hands
Am J Infect Control
(1981)- et al.
Twenty-four-hour observational study of hospital hand hygiene compliance
J Hosp Infect
(2010) - et al.
Hand washing patterns in two dermatology clinics
Dermatology
(2002) - et al.
Introduction of a waterless alcohol-based hand rub in a long-term-care facility
Infect Control Hosp Epidemiol
(2003) - et al.
The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations
Infect Control Hosp Epidemiol
(2009)