1
|
Bredin D, O'Doherty D, Hannigan A, Kingston L. Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-analysis. J Hosp Infect 2022; 130:20-33. [PMID: 36089071 DOI: 10.1016/j.jhin.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Direct observation of hand hygiene compliance is the "gold standard" despite limitations and potential for bias. Previous literature highlights poorer hand hygiene compliance amongst physicians than nurses and suggests that covert monitoring may give better compliance estimates than overt monitoring. AIM This review aimed to explore differences in compliance between physicians and nurses further, and to analyse if compliance estimates differed when observations were covert rather than overt. METHODS A systematic search of databases PubMed, EMBASE, CENTRAL and CINAHL was performed. Experimental or observational studies in hospital settings in high-income countries published in English from 2010 onwards were included if estimates for both physicians and nurses using direct observation were reported. The search yielded 4814 studies, of which 105 were included. FINDINGS The weighted pooled compliance rate for nurses was 52% (95% CI 47% to 57%) and for doctors was 45% (95% CI 40% to 49%). Heterogeneity was considerable (I2=99%). The majority of studies were at moderate or high risk of bias. Random-effects meta-analysis of low risk of bias studies suggests higher compliance for nurses than physicians for both overt (difference of 7%, 95% CI for the difference 0.8% to 13.5%, p=0.027) and covert (difference of 7%, 95% CI 3% to 11%, p=0.0002) observation. Considerable heterogeneity was found in all analyses. CONCLUSION Wide variability in compliance estimates and differences in the methodological quality of hand hygiene studies were identified. Further research with meta-regression should explore sources of heterogeneity and improve the conduct and reporting of hand hygiene studies.
Collapse
Affiliation(s)
- D Bredin
- School of Medicine, University of Limerick, Ireland
| | - D O'Doherty
- School of Medicine, University of Limerick, Ireland
| | - A Hannigan
- School of Medicine, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - L Kingston
- Department of Nursing and Midwifery, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland.
| |
Collapse
|
2
|
Issa M, Dunne SS, Dunne CP. Hand hygiene practices for prevention of health care-associated infections associated with admitted infectious patients in the emergency department: a systematic review. Ir J Med Sci 2022; 192:871-899. [PMID: 35435564 PMCID: PMC10066077 DOI: 10.1007/s11845-022-03004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/01/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Background
In most high-income countries, emergency departments (ED) represent the principal point of access forcer by critically ill or injured patients. Unlike inpatient units, ED healthcare workers (ED HCWs) have demonstrated relative lack of adherence to hand hygiene (HH) guidelines, commonly citing frequency of intervention and high rates of admission, which reflect severity of cases encountered.
Aim
Assessment of studies on hand hygiene compliance (HHC) by ED HCWs conducted between 2010 and 2020, seeking to estimate HHC rates and intervention strategies utilised to improve HHC in EDs.
Methods
Searches conducted in Web of Science, EBSCO HOST (CINHAL & Medline), PubMed, Embase, and Cochrane for full studies published between 2010 and 2020 on the topic of HHC in the ED.
Results
One hundred twenty-nine eligible articles were identified of which 79 were excluded. Fifty-one underwent full-text screening before 20 studies were deemed relevant. Of the eligible studies, fifteen (75%) had, as the primary outcome, HHC according to the WHO-recommended 5-moments. Twelve studies (60%) implemented multimodal or single intervention strategies. Eight studies were ambiguous regarding the nature of the approach adopted. In the nine observational studies where HHC was documented, an overall post-intervention median HHC rate of 45% (range 8–89.7%).
Conclusion
Multimodal approaches appear to have enhanced HHC moderately among ED HCWs. Elevated complexity associated with critically ill patients, and ED overcrowding, are contributing factors to relatively low compliance rates observed. Strategies to improve HHC rates may need to acknowledge, and cater for, the context of an unpredictable environment.
Collapse
Affiliation(s)
- M Issa
- School of Medicine, University of Limerick, Master's in Public Health Programme, Limerick, Ireland
| | - S S Dunne
- Centre for Interventions in Infection, Inflammation & Immunity (4I) and School of Medicine, University of Limerick, Limerick, Ireland
| | - C P Dunne
- Centre for Interventions in Infection, Inflammation & Immunity (4I) and School of Medicine, University of Limerick, Limerick, Ireland.
| |
Collapse
|
3
|
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] [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.
Collapse
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
| |
Collapse
|
4
|
Saitoh A, Sato K, Magara Y, Osaki K, Narita K, Shioiri K, Fowler KE, Ratz D, Saint S. Improving Hand Hygiene Adherence in Healthcare Workers Before Patient Contact: A Multimodal Intervention in Four Tertiary Care Hospitals in Japan. J Hosp Med 2020; 15:262-267. [PMID: 32379022 DOI: 10.12788/jhm.3446] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/12/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hand hygiene is key to preventing healthcare-associated infection and the spread of respiratory viruses like the novel coronavirus that causes COVID-19. Unfortunately, hand hygiene adherence of healthcare workers (HCWs) in Japan is suboptimal according to previous studies. OBJECTIVES Our objectives were to evaluate hand hygiene adherence among physicians and nurses before touching hospitalized patients and to evaluate changes in hand hygiene adherence after a multimodal intervention was implemented. DESIGN, SETTING, AND PARTICIPANTS We conducted a pre- and postintervention study with HCWs at four tertiary hospitals in Niigata, Japan. Hand hygiene observations were conducted from June to August 2018 (preintervention) and February to March 2019 (postintervention). INTERVENTION The multimodal hand hygiene intervention recommended by the World Health Organization was tailored to each hospital and implemented from September 2018 to February 2019. MAIN OUTCOMES AND MEASURES We observed hand hygiene adherence before touching patients in each hospital and compared rates before and after intervention. Intervention components were also evaluated. RESULTS There were 2,018 patient observations preintervention and 1,630 postintervention. Overall, hand hygiene adherence improved from 453 of 2,018 preintervention observations (22.4%) to 548 of 1,630 postintervention observations (33.6%; P < .001). Rates improved more among nurses (13.9 percentage points) than among doctors (5.7 percentage points). Improvement varied among the hospitals: Hospital B (18.4 percentage points) was highest, followed by Hospitals D (11.4 percentage points), C (11.3 percentage points), and Hospital A (6.5 percentage points). CONCLUSIONS A multimodal intervention improved hand hygiene adherence rates in physicians and nurses in Niigata, Japan; however, further improvement is necessary. Given the current suboptimal hand hygiene adherence rates in Japanese hospitals, the spread of COVID-19 within the hospital setting is a concern.
Collapse
Affiliation(s)
- Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata Japan
| | - Kiyomi Sato
- Department of Nursing, Niigata Saiseikai Daini Hospital, Niigata, Japan
| | - Yoko Magara
- Department of Nursing, Niigata Saiseikai Daini Hospital, Niigata, Japan
| | - Kakuei Osaki
- Department of Nursing, Niigata City General Hospital, Niigata, Japan
| | - Kiyoko Narita
- Department of Nursing, Naga-oka Red Cross Medical Center, Niigata, Japan
| | - Kumiko Shioiri
- Department of Nursing, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Karen E Fowler
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - David Ratz
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Sanjay Saint
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| |
Collapse
|
5
|
Lambe K, Lydon S, Madden C, McSharry J, Marshall R, Boylan R, Hehir A, Byrne M, Tujjar O, O'Connor P. Understanding hand hygiene behaviour in the intensive care unit to inform interventions: an interview study. BMC Health Serv Res 2020; 20:353. [PMID: 32334574 PMCID: PMC7183607 DOI: 10.1186/s12913-020-05215-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/13/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Improving hand hygiene (HH) compliance is one of the most important, but elusive, goals of infection control. The purpose of this study was to use the capability (C), opportunity (O), motivation (M), and behaviour (B; COM-B) model and the theoretical domains framework (TDF) to gain an understanding of the barriers and enablers of HH behaviours in an intensive care unit (ICU) in order to identify specific interventions to improve HH compliance. METHODS A semi-structured interview schedule was developed based upon the COM-B model. This schedule was used to interview a total of 26 ICU staff: 12 ICU nurses, 11 anaesthetic specialist registrars, and three anaesthetic senior house officers. RESULTS Participants were confident in their capabilities to carry out appropriate HH behaviours. The vast majority of participants reported having the necessary knowledge and skills, and believed they were capable of carrying out appropriate HH behaviours. Social influence was regarded as being important in encouraging HH compliance by the interviewees- particularly by nurses. The participants were motivated to carry out HH behaviours, and it was recognised that HH was an important part of their job and is important in preventing infection. It is recommended that staff are provided with targeted HH training, in which individuals receive direct and individualised feedback on actual performance and are provided guidance on how to address deficiencies in HH compliance at the bedside at the time at which the HH behaviour is performed. Modelling of appropriate HH behaviours by senior leaders is also suggested, particularly by senior doctors. Finally, appropriate levels of staffing are a factor that must be considered if HH compliance is to be improved. CONCLUSIONS This study has demonstrated that short interviews with ICU staff, founded on appropriate behavioural change frameworks, can provide an understanding of HH behaviour. This understanding can then be applied to design interventions appropriately tailored to the needs of a specific unit, which will have an increased likelihood of improving HH compliance.
Collapse
Affiliation(s)
- Kathryn Lambe
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Caoimhe Madden
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Jenny McSharry
- School of Psychology, National University of Ireland Galway, Co. Galway, Ireland
| | - Rebecca Marshall
- Department of Anaesthesia & Intensive Care, University Hospital Galway, Co. Galway, Ireland
| | - Ruth Boylan
- The College of Anaesthesiologists of Ireland, Dublin, Ireland
- Department of Anaesthetics, Sligo University Hospital, Sligo, Ireland
| | - Aoife Hehir
- School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Molly Byrne
- School of Psychology, National University of Ireland Galway, Co. Galway, Ireland
| | - Omar Tujjar
- Department of Anaesthetics, Sligo University Hospital, Sligo, Ireland
| | - Paul O'Connor
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland.
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland.
| |
Collapse
|
6
|
Longembe EB, Kitronza PL. [Compliance with hand-hygiene practice in the General Reference Hospitals of the city of Kisangani, Democratic Republic of the Congo]. Pan Afr Med J 2020; 35:57. [PMID: 32537061 PMCID: PMC7266366 DOI: 10.11604/pamj.2020.35.57.18500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 11/25/2019] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION the purpose of this study was to assess the compliance with hand-hygiene practice of health-care workers in the General Reference Hospitals (GRH) of the city of Kisangani and to identify factors contributing to it. METHODS we conducted a cross-sectional study in the Maternity, Surgery, Pediatric and Emergency Departments at four GRH of the city of Kisangani over the period 13th-20th June 2018. One hundred and twenty professionals recruited from among doctors, nurses, laboratory technicians and attendants were asked to complete a self-administered questionnaire to assess their level of knowledge and a grid indicating the compliance with hand-hygiene practice in 44 health professionals (1920 opportunities). RESULTS the rate of overall compliance with hand-hygiene practice was 39% [CI95 0.37; 0.41]; friction with hydroalcoholic solution was much less frequent (5%); cleaners and physicians had higher compliance rates (49% and 44% respectively) than nurses (33%). Approximately one third of professionals were aware of the indications for hand-hygiene according to the WHO; 37% of health professionals declared that they had followed a on-the-job training on hand-hygiene and 36% knew the importance of hand-hygiene in the healthcare environment. The gap in knowledge was not significant between the occupational categories studied (p >0.05). CONCLUSION this study and the results obtained from it allowed us to conclude that the level of compliance to precautions standards including hand hygiene by healthcare professionals is insufficient. It is therefore necessary to strengthen the compliance with hand-hygiene practices through training and awareness programs for healthcare professionals, the supply of hygiene products and the awareness of healthcare providers.
Collapse
Affiliation(s)
- Eugène Basandja Longembe
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | - Panda Lukongo Kitronza
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
- Ecole de Santé Publique, Faculté de Médecine, Université de Liège, Liège, Belgique
| |
Collapse
|
7
|
Sakihama T, Kayauchi N, Kamiya T, Saint S, Fowler KE, Ratz D, Sato Y, Iuchi R, Honda H, Tokuda Y. Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals. Am J Infect Control 2020; 48:77-81. [PMID: 31345615 DOI: 10.1016/j.ajic.2019.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Our goal was to evaluate the 5-year sustainability of a multimodal intervention that included a prize to the hospital with the highest overall hand hygiene adherence rates among health care workers. METHODS We conducted an observational study in 3 Japanese tertiary care hospitals using unobtrusive direct observation of physician and nurse hand hygiene adherence. Observations were performed by a trained observer on inpatient medical, surgical, intensive care, and emergency units. The primary outcome was hand hygiene adherence rates before patient contact. Secondary outcomes were health care worker survey responses to a World Health Organization (WHO) questionnaire on hand hygiene practices. RESULTS Hand hygiene adherence rates had improved significantly after the introduction of a multimodal intervention (based on principles recommend by the WHO) in 2012 and 2013 (from 18.0% pre-intervention to 32.7% 6 months post-intervention; P < .001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5 years after intervention; P = .53); however, substantial variability in hand hygiene adherence by unit and health care worker type was noted. CONCLUSIONS A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention.
Collapse
|
8
|
Valim MD, Rocha ILDS, Souza TPM, Cruz YAD, Bezerra TB, Baggio É, Morais RBD, Ribeiro AC. Efficacy of the multimodal strategy for Hand Hygiene compliance: an integrative review. Rev Bras Enferm 2019; 72:552-565. [PMID: 31017221 DOI: 10.1590/0034-7167-2018-0584] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/01/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Evaluate, from the literature, the effectiveness of the implementation of the multimodal strategy for health professionals compliance with Hand Hygiene and its sustainability over time. METHOD Integrative review, with a view to answering the following question: "Is the implementation of the multimodal strategy effective in health professionals compliance with Hand Hygiene and can it be sustained over time?". The MEDLINE, SCOPUS, LILACS and CINAHL databases were used to retrieve the primary articles. RESULTS Twenty-five studies were analyzed. Among the components of the multimodal strategy, three need to be better worked: health education, feedback from practices and management involvement. Although it needs to focus more on its five elements, interventions based on the multimodal strategy have favored HH compliance and its long-term sustainability. CONCLUSION The strategy proved to be effective for HH compliance, especially when all integrating components are adequately addressed.
Collapse
Affiliation(s)
| | | | | | | | | | - Érica Baggio
- Universidade Federal de Mato Grosso,Faculdade de Enfermagem. Cuiabá-MT, Brasil
| | | | | |
Collapse
|
9
|
Ara L, Bashar F, Tamal MEH, Siddiquee NKA, Mowla SMN, Sarker SA. Transferring knowledge into practice: a multi-modal, multi-centre intervention for enhancing nurses' infection control competency in Bangladesh. J Hosp Infect 2018; 102:234-240. [PMID: 30081147 DOI: 10.1016/j.jhin.2018.07.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/30/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nurses are considered as the key to infection prevention as they play a major role in treatment as well as taking care of patients. AIM To assess the role of a multi-modal intervention (MMI) in improving nurses' competency and adherence to standard infection control practices in Bangladesh. METHODS The study adopted a pretest-post-test intervention approach, in three different periods (from 2012 to 2017) in five hospitals (two public, two private, and one autonomous) in Bangladesh. Each study period was divided into three phases: pretest, MMI, and post-test. Data were collected on 642 nurses using direct observation method through a structured checklist. FINDINGS After implementing the MMI, overall hand hygiene compliance significantly increased before patient contact (from 1.3% to 50.2%; P < 0.000) and after patient contact (from 2.8% to 59.6%; P < 0.000). Remarkable improvements were also achieved in adherence to use of gloves (from 14.6% to 57.6%; P < 0.000), maintaining sterility of equipment during aseptic techniques (from 34.9% to 86%; P < 0.000), biomedical waste segregation (from 1.8% to 81.3%; P < 0.000) and labelling of procedural sites (from 0% to 85.7%; P < 0.000). Moreover, needlestick injury rate notably decreased (from 6.2% to 0.6%; P < 0.000). CONCLUSION MMI can play a vital role in improving nurses' compliance with the standard infection control practices. Such context-specific interventions, which are crucial for preventing healthcare-associated infections and for decreasing occupational hazards, should be replicated in resource-poor countries for achieving universal health coverage by 2030.
Collapse
Affiliation(s)
- L Ara
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh.
| | - F Bashar
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh
| | - M E H Tamal
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh
| | - N K A Siddiquee
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh
| | - S M N Mowla
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh
| | - S A Sarker
- Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh
| |
Collapse
|
10
|
Rigby R, Pegram A, Woodward S. Hand decontamination in clinical practice: a review of the evidence. ACTA ACUST UNITED AC 2017; 26:448-451. [DOI: 10.12968/bjon.2017.26.8.448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ruth Rigby
- Adult nursing student, Florence Nightingale Faculty of Nursing and Midwifery, King's College London
| | - Anne Pegram
- Lecturer, Florence Nightingale Faculty of Nursing and Midwifery, King's College London
| | - Sue Woodward
- Lecturer, Head of Clinical Education, Florence Nightingale Faculty of Nursing and Midwifery, King's College London
| |
Collapse
|
11
|
Sopjani I, Jahn P, Behrens J. Training as an Effective Tool to Increase the Knowledge About Hand Hygiene Actions. An Evaluation Study of Training Effectiveness in Kosovo. Med Arch 2017; 71:16-19. [PMID: 28428667 PMCID: PMC5364797 DOI: 10.5455/medarh.2017.71.16-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Hand hygiene (HH) compliance with World Health Organization (WHO) guidelines is essential to prevent bacterial transmission and infections acquired from hospital settings. Aim: The aim of this study was to evaluate the impact of training tool of World Health Organization’s (WHOs) Hand Hygiene multi modal campaign at all public hospitals and at the University Clinical Center in Kosovo (UCCK). Method: During February 2016, 691 questionnaires were distributed to health care workers. The data collection was conducted through a questionnaire distributed before and after training. Measurement of questions was realized through a 5 point Likert scale. Results: The gender structure of participants turned out to be greater for women (n=571, 85%). The knowledge of health care workers differed significantly before and after the training (p<0.001), emphasizing that the impact of the training was important to improve the knowledge of participants. Thus, the average value of improvement of HCW’ knowledge was about 41.66 %. Conclusion: The findings emphasized the role of the training to improve the knowledge of participants about hand hygiene as well as prevention from infection.
Collapse
|