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Casas I, Castellà L, Gimenez M, Pulido A, Sopena N, Ciércoles A, Mena G, Reina D, López R, Garcia-Quesada MJ. Impact of a multimodal intervention on compliance with hand hygiene among health care workers of a tertiary hospital. Med Clin (Barc) 2022; 159:426-431. [PMID: 35210097 DOI: 10.1016/j.medcli.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/19/2021] [Accepted: 12/27/2021] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Hand hygiene (HH) is the simplest and most effective measure for the prevention of infection related to healthcare. Despite this, compliance in healthcare professionals continues to be suboptimal. The aim of this study is to assess the impact of an expanded World Health Organization (WHO) multimodal strategy on HH compliance in healthcare personnel. MATERIAL AND METHODS A quasi-experimental before-after study was designed, carrying out the expanded WHO multimodal strategy in 2018, aimed at professionals in a tertiary hospital. In this strategy, apart from applying the 5 pillars of the WHO, a video was made, the administration of the WHO perceptions questionnaire and an incentive to the service/unit with better compliance, adding to the training a modality of practical workshops. The compliance percentages for 2017 and 2018 were compared. RESULTS In 2017, 1056 opportunities were observed, registering 631 HH actions, with global compliance of 60% (95% CI 56.7-62.7). In 2018, with 1481 opportunities observed and 1111 HH actions, compliance was 75% (95% CI 72.7-77.2) (P<.001). This compliance increased in all professional categories and in all indications. CONCLUSIONS The application of an expanded multimodal strategy has a positive impact on HH compliance. Strategies should be directed to the categories with the worst compliance and continuously over time.
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Affiliation(s)
- Irma Casas
- Servicio de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España
| | - Laia Castellà
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Montse Gimenez
- Servicio de Microbiología, Laboratorio Clínico Metropolitana Norte, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Ana Pulido
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Nieves Sopena
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España; Servicio de Enfermedades Infecciosas, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Anna Ciércoles
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Guillermo Mena
- Servicio de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España
| | - Dina Reina
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Raúl López
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Maria-José Garcia-Quesada
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
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ANWAR M, ELAREED H. Improvement of hand hygiene compliance among health care workers in intensive care units. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E31-E35. [PMID: 31041408 PMCID: PMC6477560 DOI: 10.15167/2421-4248/jpmh2019.60.1.918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 12/03/2018] [Indexed: 01/11/2023]
Abstract
Aim Hand hygiene (HH) is an essential component in preventing healthcare associated infections. The purpose of this study was to evaluate HH compliance among health care workers (HCWs) in intensive care units at Beni-Suef university hospital, Egypt before and after an intervention educational program. Methods Data were collected by using the standardized WHO method for direct observation ‘‘Five moments for HH’’ approach. Observations were conducted in six ICUs before intervention (March to April 2017) and after the intervention (July to August 2017). The study included 608 opportunities (observations) among 177 HCWs collected before and 673 opportunities among 163 HCWs collected after the intervention. Results Overall HH compliance increased significantly from 30.9 (95% CI: 27.2-34.6%) before intervention to 69.5 (95% CI: 65.2-72.6%) post intervention; with the highest HH compliance rate among nurses compared to physicians and workers (P = 0.001). Significantly higher HH compliance rates were observed after body fluid exposure, before aseptic procedures, and after patient contact compared to before patient contact and after patient surrounding contact (P = 0.001). In binary logistic regression analyses a statistically significant difference was shown (P = 0.047) for HH compliance among events before and after patient contact (OR = 1.399, 95% CI: 1.004-1.948). Conclusions The interventional educational program improved the HH compliance among ICUs-HCWs at Beni-Suef university hospital. The hospital should conduct monthly observational monitoring for the ICUs units sharing the findings to spread best practices. Provision of sustained training programs to help efficient and effective HH for care delivery is mandatory.
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Affiliation(s)
- M.M ANWAR
- Manal Mohamed Anwar, Public Health and Community Medicine Department, Faculty of Medicine, Beni-Suef University, Egypt - Tel +20 82 2324879 - Fax +20 82 2333367 - E-mail:
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Jam R, Mesquida J, Hernández Ó, Sandalinas I, Turégano C, Carrillo E, Pedragosa R, Valls J, Parera A, Ateca B, Salamero M, Jane R, Oliva JC, Delgado-Hito P. Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: a multicentre study. Nurs Crit Care 2018; 23:291-298. [DOI: 10.1111/nicc.12380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Rosa Jam
- Critical Care Department; Parc Taulí. Hospital Universitari; Sabadell Spain
| | - Jaume Mesquida
- Critical Care Department; Parc Taulí. Hospital Universitari; Sabadell Spain
| | | | | | | | - Esther Carrillo
- Critical Care Department; Parc Taulí. Hospital Universitari; Sabadell Spain
| | - Rosario Pedragosa
- Critical Care Department; Parc Taulí. Hospital Universitari; Sabadell Spain
| | - Josefa Valls
- Critical Care Department; Hospital Universitari Mútua de Terrassa; Terrassa Spain
| | - Ana Parera
- Critical Care Department; Hospital Universitari Mútua de Terrassa; Terrassa Spain
| | - Begoña Ateca
- Critical Care Department; Hospital Universitari Mútua de Terrassa; Terrassa Spain
| | - Maria Salamero
- Critical Care Department; Hospital Universitari Mútua de Terrassa; Terrassa Spain
| | - Roser Jane
- Critical Care Department; Hospital Universitari Mútua de Terrassa; Terrassa Spain
| | - Joan Carles Oliva
- Department of Results Centers; Fundació Parc Taulí, Unit of Clinical Trials; Sabadell Spain
| | - Pilar Delgado-Hito
- Fundamental and Medical-Surgical Nursing Department, School of Nursing; University of Barcelona; Barcelona Spain
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Jam R, Hernández O, Mesquida J, Turégano C, Carrillo E, Pedragosa R, Gómez V, Martí L, Vallés J, Delgado-Hito P. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study. ENFERMERIA INTENSIVA 2017; 28:178-186. [PMID: 28890209 DOI: 10.1016/j.enfi.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. RESULTS Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. CONCLUSIONS Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors.
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Affiliation(s)
- R Jam
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - O Hernández
- Servicio de Atención Primaria, Vallés Occidental, Sabadell, Barcelona, España
| | - J Mesquida
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - C Turégano
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - E Carrillo
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - R Pedragosa
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - V Gómez
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - L Martí
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - J Vallés
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - P Delgado-Hito
- Departamento de Enfermería Fundamental y Médico-Quirúrgica, Escuela de Enfermería, Universidad de Barcelona, Barcelona, España; Miembro del Grupo GRIN-IDIBELL.
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Škodová M, Gimeno-Benítez A, Martínez-Redondo E, Morán-Cortés JF, Jiménez-Romano R, Gimeno-Ortiz A. Hand hygiene technique quality evaluation in nursing and medicine students of two academic courses. Rev Lat Am Enfermagem 2017; 23:708-17. [PMID: 26444174 PMCID: PMC4623734 DOI: 10.1590/0104-1169.0459.2607] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: because they are health professionals, nursing and medical students' hands during
internships can function as a transmission vehicle for hospital-acquired
infections. Method: a descriptive study with nursing and medical degree students on the quality of
the hand hygiene technique, which was assessed via a visual test using a
hydroalcoholic solution marked with fluorescence and an ultraviolet lamp. Results: 546 students were assessed, 73.8% from medicine and 26.2% from nursing. The area
of the hand with a proper antiseptic distribution was the palm (92.9%); areas not
properly scrubbed were the thumbs (55.1%). 24.7% was very good in both hands,
29.8% was good, 25.1% was fair, and 20.3% was poor. The worst assessed were the
male, nursing and first year students. There were no significant differences in
the age groups. Conclusions: hand hygiene technique is not applied efficiently. Education plays a key role in
setting a good practice base in hand hygiene, theoretical knowledge, and in skill
development, as well as good practice reinforcement.
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Affiliation(s)
- Manuela Škodová
- Faculdad de Medicina, Universidad de Extremadura, Badajoz, Extremadura, ES
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Mahfouz AA, Al-Zaydani IA, Abdelaziz AO, El-Gamal MN, Assiri AM. Changes in hand hygiene compliance after a multimodal intervention among health-care workers from intensive care units in Southwestern Saudi Arabia. J Epidemiol Glob Health 2014; 4:315-21. [PMID: 25455649 PMCID: PMC7320339 DOI: 10.1016/j.jegh.2014.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/08/2014] [Accepted: 05/12/2014] [Indexed: 12/02/2022] Open
Abstract
The aim of this study is to measure the degree of compliance with hand hygiene practices among health-care workers (HCWs) in intensive care facilities in Aseer Central Hospital, Abha, Saudi Arabia, before and after a multimodal intervention program based on WHO strategies. Data were collected by direct observation of HCWs while delivering routine care using standardized WHO method: “Five moments for hand hygiene approach”. Observations were conducted before (February–April 2011) and after (February–April 2013) the intervention by well-trained, infection-control practitioners during their routine visits. The study included 1182 opportunities (observations) collected before and 2212 opportunities collected after the intervention. The overall, hand hygiene compliance increased significantly from 60.8% (95% CI: 57.9–63.6%) before the intervention to reach 86.4% (95% CI: 84.9–97.8%) post-intervention (P = 0.001). The same trend was observed in different intensive care facilities. In logistic regression analyses, HCWs were significantly more compliant (aOR = 3.2, 95% CI: 2.6–3.8) after the intervention. Similarly, being a nurse and events after patient contact were significant determinants of compliance. It is important to provide sustained intensified training programs to help embed efficient and effective hand hygiene into all elements of care delivery. New approaches like accountability, motivation and sanctions are needed.
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Affiliation(s)
- Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
| | - Ibrahim A Al-Zaydani
- Pediatric Department, Aseer Central Hospital, Abha, Saudi Arabia; Infection Control Department, Aseer Central Hospital, Abha, Saudi Arabia
| | - Ali O Abdelaziz
- Infection Control Department, Aseer Central Hospital, Abha, Saudi Arabia
| | - Mohammad N El-Gamal
- General Directorate of Infection Prevention and Control in Healthcare Facilities, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah M Assiri
- General Directorate of Infection Prevention and Control in Healthcare Facilities, Ministry of Health, Riyadh, Saudi Arabia
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