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Eksici I, Tastan S. Analysis of the relationship between fear of coronavirus and hand hygiene beliefs and practices of surgical nurses: A descriptive and cross-sectional study. Int J Nurs Pract 2024; 30:e13266. [PMID: 38747062 DOI: 10.1111/ijn.13266] [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: 02/13/2022] [Revised: 03/24/2023] [Accepted: 04/30/2024] [Indexed: 10/03/2024]
Abstract
AIM This study aimed to analyse the relationship between fear of COVID-19 and hand hygiene beliefs and practices of surgical nurses. METHOD This article is a descriptive correlational study. It was conducted between February and May 2021 with 306 surgical nurses working at public and private hospitals in Northern Cyprus. A personal information form, Fear of COVID-19 Scale, Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory were used for data collection. RESULTS Of the participants in the study, 25.41% were 29 years old or younger and 85.15% were female. The mean scores obtained from the Fear of COVID-19 Scale, Hand Hygiene Belief Scale and the Hand Hygiene Practices Inventory were 23.12 ± 8.03, 81.33 ± 7.67 and 69.15 ± 1.94, respectively. The Fear of COVID-19 Scale scores were negatively correlated with the Hand Hygiene Belief Scale scores and positively correlated with the Hand Hygiene Practices Inventory scores. CONCLUSION Hand hygiene practices were better for nurses with higher level of COVID-19 fear. Therefore, a high level of seriousness and awareness of nurses about hand hygiene, which was achieved during the COVID-19 pandemic, should be sustained to maintain proper hand hygiene practices.
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Affiliation(s)
- Ilayda Eksici
- Dr. Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus, Turkey
| | - Sevinc Tastan
- Health Sciences Faculty, Nursing Department, Eastern Mediterranean University, Famagusta, North Cyprus, Turkey
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2
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Izumi M, Hagiya H, Otsuka Y, Soejima Y, Fukushima S, Shibata M, Hirota S, Koyama T, Otsuka F, Gofuku A. Effectiveness of sensing gloves-applied virtual reality education system on hand hygiene practice: A randomized controlled trial. Am J Infect Control 2024:S0196-6553(24)00639-4. [PMID: 39127185 DOI: 10.1016/j.ajic.2024.08.003] [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: 05/01/2024] [Revised: 08/04/2024] [Accepted: 08/06/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND We developed a virtual reality (VR) education system and evaluated its clinical utility for promoting hand hygiene practices. METHODS This prospective, 2-week, randomized controlled study conducted at Okayama University Hospital, Japan, from November 2023 to January 2024, involved 22 participants (18 medical students and 4 residents). A fully immersive 360° VR system (VIVE Pro Eye) using a head-mounted display and sensing gloves was used to develop 3 health care tasks in a virtual patient room-Environmental Cleaning, Gauze Exchange, and Urine Collection. After monitoring all participants' baseline usage data of portable hand-rubbing alcohol in the first week, we randomly assigned them into 1:1 groups (VR training and video lecture groups). The primary outcome was differences in hand-rubbed alcohol use before and after intervention. RESULTS Before the intervention, alcohol use did not significantly differ between both groups. After the intervention, a significant increase in alcohol use was observed in the VR training group (median: 8.2 g vs 16.2 g; P = .019) but not in the video lecture group. CONCLUSIONS Our immersive 360° VR education system enhanced hand hygiene practices. Infection prevention and control practitioners and digital technology experts must collaborate to advance the development of superior educational devices and content.
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Affiliation(s)
- Mahiro Izumi
- Quality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan.
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshiaki Soejima
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Mitsunobu Shibata
- Quality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Satoshi Hirota
- Quality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Toshihiro Koyama
- Department of Health Data Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akio Gofuku
- Quality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
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3
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Hagiya H, Fujita Y, Kiguchi T, Higashionna T. Another factor with an adverse effect on hand hygiene compliance. J Hosp Infect 2024; 149:201-202. [PMID: 38403084 DOI: 10.1016/j.jhin.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Affiliation(s)
- H Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan.
| | - Y Fujita
- Department of Nursing, Okayama University Hospital, Okayama, Japan
| | - T Kiguchi
- Department of Nursing, Okayama University Hospital, Okayama, Japan
| | - T Higashionna
- Department of Pharmacy, Okayama University Hospital, Okayama, Japan
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Fujita R, Arbogast JW, Yoshida R, Hori S. A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption. Infect Prev Pract 2022; 4:100256. [PMID: 36387608 PMCID: PMC9646915 DOI: 10.1016/j.infpip.2022.100256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The World Health Organization recommends monitoring alcohol-based handrub (ABHR) consumption and direct observation of hand hygiene practices to ensure compliance. In Japan monitoring of ABHR consumption is widely performed. However, direct observation is not common, particularly in small facilities and non-acute-care facilities. Hence, the current study aimed to evaluate the longitudinal effects of direct observation of hand hygiene practices and monitoring of ABHR consumption with provision of feedback to healthcare personnel on ABHR consumption and hand hygiene compliance. Methods We conducted a 4-year prospective intervention study. Monitoring of ABHR consumption and direct observation of hand hygiene practices with monthly feedback to healthcare personnel was implemented in 17 facilities. These consisted of 11 acute-care facilities of varying sizes and six non-acute-care facilities. A generalized linear mixed model analysis was performed to assess factors associated with ABHR consumption. Results All facilities implemented ABHR consumption monitoring within one month of starting the study. However, the mean time required to implement direct observation of hand hygiene practices was 24.7 (±19.1) months. The ABHR consumption increased significantly (P<0.0001) in all medical facilities after implementing the direct observation. Multivariable regression analysis showed the hospital ward type, duration of ABHR consumption monitoring, and duration of direct observation of hand hygiene practices were independently associated with ABHR consumption. Conclusions Direct observation of hand hygiene practices with feedback should be implemented more widely in combination with ABHR consumption monitoring to help increase hand hygiene compliance.
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Affiliation(s)
- Retsu Fujita
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | | | - Rika Yoshida
- Division of Infection Prevention and Control, Postgraduate School, Tokyo Healthcare University, Tokyo, Japan
| | - Satoshi Hori
- Department of Infection Control Science, Juntendo University School of Medicine, Tokyo, Japan
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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.
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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.
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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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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Hagiya H, Takase R, Sazumi Y, Nishimura Y, Honda H, Otsuka F. Gap between self-evaluation and actual hand hygiene compliance among health-care workers. J Infect Prev 2022; 23:239-242. [PMID: 36003134 PMCID: PMC9393601 DOI: 10.1177/17571774221094160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/22/2022] [Accepted: 02/24/2022] [Indexed: 09/03/2023] Open
Abstract
Hand hygiene (HH) compliance among health-care workers has not satisfactorily improved despite multiple educative approaches. Between October 2019 and February 2020, we performed a self-evaluation test and a direct observation for the compliance of the 5 Moments for Hand Hygiene program advocated by the World Health Organization at two Japanese hospitals. Average percentages of self-evaluated HH compliance were as follows: (i) 76.9% for "Before touching a patient," (ii) 85.8% for "Before clean/aseptic procedures," (iii) 95.9% for "After body fluid exposure/risk," (iv) 84.0% for "After touching a patient," and (v) 69.2% for "After touching patient surroundings." On the other hand, actual HH compliance was 11.7% for "Before touching a patient" and 18.0% for "After touching a patient or patient surroundings." The present study demonstrated a big gap between self-evaluation and actual HH compliance among nurses working at hospitals, indicating the need of further providing the education in infection prevention.
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Affiliation(s)
- Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryosuke Takase
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Sazumi
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan
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8
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Impact of the world hand hygiene and global handwashing days on public awareness between 2016 and 2020: Google trends analysis. Am J Infect Control 2022; 50:141-147. [PMID: 34718066 DOI: 10.1016/j.ajic.2021.08.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear. METHODS This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis. RESULTS Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods. CONCLUSIONS While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits.
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Madden C, Lydon S, Walsh C, O'Dowd E, Fox S, Vellinga A, Lambe K, Tujjar O, Greally C, Power M, Bates J, O'Connor P. What are the predictors of hand hygiene compliance in the intensive care unit? A cross-sectional observational study. J Infect Prev 2021; 22:252-258. [PMID: 34880947 PMCID: PMC8647638 DOI: 10.1177/17571774211033351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Although appropriate hand hygiene (HH) practices are recognised as the most
effective preventative strategy for infection, adherence is suboptimal.
Previous studies in intensive care units (ICUs) have found differences in HH
compliance between those moments that protect the patient, and those that
protect the healthcare provider. However, such studies did not control for
other variables known to impact HH compliance. Aim: To examine HH among healthcare workers (HCWs) in ICU settings, and identify
whether there is a statistical difference in HH compliance between
patient-protective and self-protective moments, while controlling for other
variables known to influence HH compliance (i.e. professional role, unit and
shift time). Methods: A cross-sectional observational study was conducted in four ICUs across three
Irish hospitals. Compliance was assessed according to the WHO’s ‘five
moments for hand hygiene’. HCW professional role, total number of
‘opportunities’ for HH and whether compliance was achieved were
recorded. Results: A total of 712 HH opportunities were recorded, with an overall compliance
rate of 56.9%. Logistic regression analysis revealed that physicians, allied
healthcare professionals and auxiliary staff were less likely than nurses to
engage in HH. HCWs were more likely to comply during night shifts compared
to morning shifts, and with self-protective as compared to
patient-protective HH moments. Conclusion: The information provided in this study provides a data-driven approach that
ICUs can use to tailor HH interventions to where, when and for whom they are
most required.
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Affiliation(s)
- Caoimhe Madden
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation.,School of Medicine, National University of Ireland, Galway
| | - Chloe Walsh
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation
| | - Emily O'Dowd
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation
| | - Susan Fox
- Health Services Executive, Dublin, Ireland
| | - Akke Vellinga
- School of Medicine, National University of Ireland, Galway
| | - Kathryn Lambe
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation
| | | | | | - Michael Power
- Critical Care Programme, National Clinical Programmes, Health Services Executive, Dublin, Ireland
| | - John Bates
- Galway University Hospital, Galway, Ireland
| | - Paul O'Connor
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation
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Mugambe RK, Mselle JS, Ssekamatte T, Ntanda M, Isunju JB, Wafula ST, Kansiime WK, Isubikalu P, Ssemwanga D, Yakubu H, Moe CL. Impact of mhealth messages and environmental cues on hand hygiene practice among healthcare workers in the greater Kampala metropolitan area, Uganda: study protocol for a cluster randomized trial. BMC Health Serv Res 2021; 21:88. [PMID: 33499864 PMCID: PMC7835669 DOI: 10.1186/s12913-021-06082-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/13/2021] [Indexed: 12/27/2022] Open
Abstract
Background Hand hygiene (HH) among healthcare workers (HCWs) is critical for infection prevention and control (IPC) in healthcare facilities (HCFs). Nonetheless, it remains a challenge in HCFs, largely due to lack of high-impact and efficacious interventions. Environmental cues and mobile phone health messaging (mhealth) have the potential to improve HH compliance among HCWs, however, these remain under-studied. Our study will determine the impact of mhealth hygiene messages and environmental cues on HH practice among HCWs in the Greater Kampala Metropolitan Area (GKMA). Methods The study is a cluster-randomized trial, which will be guided by the behaviour centred design model and theory for behaviour change. During the formative phase, we shall conduct 30 key informants’ interviews and 30 semi-structured interviews to explore the barriers and facilitators to HCWs’ HH practice. Besides, observations of HH facilities in 100 HCFs will be conducted. Findings from the formative phase will guide the intervention design during a stakeholders’ insight workshop. The intervention will be implemented for a period of 4 months in 30 HCFs, with a sample of 450 HCWs who work in maternity and children’s wards. HCFs in the control arm will receive innovatively designed HH facilities and supplies. HCWs in the intervention arm, in addition to the HH facilities and supplies, will receive environmental cues and mhealth messages. The main outcome will be the proportion of utilized HH opportunities out of the 9000 HH opportunities to be observed. The secondary outcome will be E. coli concentration levels in 100mls of hand rinsates from HCWs, an indicator of recent fecal contamination and HH failure. We shall run multivariable logistic regression under the generalized estimating equations (GEE) framework to account for the dependence of HH on the intervention. Discussion The study will provide critical findings on barriers and facilitators to HH practice among HCWs, and the impact of environmental cues and mhealth messages on HCWs’ HH practice. Trial registration ISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06082-3.
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Affiliation(s)
- Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | | | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Moses Ntanda
- College of Computing and Information Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Winnifred K Kansiime
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Prossy Isubikalu
- Department of Agricultural Extension and Innovations, School of Agricultural Sciences, College of Agriculture and Environmental Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - David Ssemwanga
- Environmental Health Department, Ministry of Health, P.O Box 7272, Kampala, Uganda
| | - Habib Yakubu
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Christine L Moe
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
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11
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Kato H, Takeda R, Ideno Y, Suzuki T, Sano K, Nakamura K. Physicians' compliance for hand hygiene in medical outpatient clinics: automated hand-hygiene monitoring with touch sensor and wireless internet. Am J Infect Control 2021; 49:50-54. [PMID: 32512079 DOI: 10.1016/j.ajic.2020.05.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Outpatient clinics are reservoirs for significant pathogens. Hand hygiene with alcohol-based hand rubs are measures currently in use to prevent horizontal transmission of infections. The extent of compliance with hand hygiene regulations is unclear and difficult to monitor. METHODS We built an automated monitoring system with a pressure sensor attached to the alcohol-based hand rubs containers. Wireless fidelity (WIFI)-assisted data collection took place over 9 weeks. Interventions included posters, email reminders and newsletters. Hand hygiene compliance before and after these interventions was evaluated. RESULTS Overall compliance with hand hygiene regulations was 6.48%; half of the physicians participating in our study performed hand hygiene at only 3.08% of patient visits. Twenty-four (17.9%) physicians performed hand hygiene with high compliance (≥10%), while 11.2% performed no hand hygiene at all. Physicians in academic positions and those with ≥20 years of experience performed hand hygiene less frequently than did other physicians. Compliance with hand hygiene regulations improved from 6.08% to 6.73% (P < .001) after intervention. DISCUSSION Compliance with hand hygiene among physicians in our outpatient clinics was very low and needs to improve. CONCLUSIONS Interventions improved the compliance somewhat, although additional interventions including education, training and feedback were suggested.
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Affiliation(s)
- Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan.
| | - Rie Takeda
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan; Nursing Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama, Japan
| | | | - Tomoyo Suzuki
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan
| | - Kayoko Sano
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan
| | - Kana Nakamura
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan; Nursing Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama, Japan
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12
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Suzuki Y, Morino M, Morita I, Yamamoto S. The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study. Antimicrob Resist Infect Control 2020; 9:75. [PMID: 32460892 PMCID: PMC7251720 DOI: 10.1186/s13756-020-00732-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/08/2020] [Indexed: 01/09/2023] Open
Abstract
Background A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score. Methods The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients. Results The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01). Conclusions A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.
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Affiliation(s)
- Yumi Suzuki
- Department of Pediatrics, National Hospital Organization (NHO) Shimoshizu National Hospital, 934-5 Shikawatashi, Yotsukaido, 284-0003, Chiba, Japan. .,Division of Infection Control, NHO Shimoshizu National Hospital, Yotsukaidou, Japan.
| | - Motoko Morino
- Division of Infection Control, NHO Shimoshizu National Hospital, Yotsukaidou, Japan.,Department of Nursing, NHO Shimoshizu National Hospital, Yotsukaidou, Japan
| | - Ichizo Morita
- Japanese Red Cross Toyota College of Nursing, 12-33 Nanamagari Hakusancho, Toyota, 471-8565, Aichi, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization (NHO) Shimoshizu National Hospital, 934-5 Shikawatashi, Yotsukaido, 284-0003, Chiba, Japan
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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.
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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
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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.
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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
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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.
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Seo HJ, Sohng KY, Chang SO, Chaung SK, Won JS, Choi MJ. Interventions to improve hand hygiene compliance in emergency departments: a systematic review. J Hosp Infect 2019; 102:394-406. [PMID: 30935982 DOI: 10.1016/j.jhin.2019.03.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/23/2019] [Indexed: 11/16/2022]
Abstract
The emergency department (ED) is where hand hygiene problems are significant as the procedures in the ED are often high risk and invasive. To date, there have been no comprehensive reviews on hand hygiene in EDs. The aim of this study was to investigate hand hygiene compliance (HHC) rate, factors affecting the HHC rate, and intervention strategies to improve HHC in EDs. Electronic databases were used to search for research published from 1948 to January 2018. The databases included ovidMEDLINE, ovidEMBASE, the Cochrane Library, CINAHL, Koreamed, and Kmbase. All study designs were included. Two reviewers independently extracted the data and assessed the bias risk using reliable and validated tools. A narrative synthesis was performed. Twenty-four studies, including 12 cross-sectional surveys and 12 interventional studies, were included. Of the 12 interventional studies reviewed, only 33% (N = 4) reported HHC rates of more than 50%. Factors that influenced HHC included types of healthcare worker, hand hygiene indication, ED crowding, positive attitudes towards HHC, patient location, auditing hand hygiene, and type of shift. Almost all of the studies (83.3%) applied multimodal or dual interventions to improve HHC. A range of strategies, including education, monitoring and providing feedback, campaigns, and cues, effectively improved HHC. The review findings indicate that there is a room for improvement in HHC in EDs. Future randomized controlled trials are necessary to determine which intervention modalities are most effective and sustainable for HHC improvement.
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Affiliation(s)
- H-J Seo
- Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea
| | - K-Y Sohng
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - S O Chang
- College of Nursing, Korea University, Seoul, South Korea
| | - S K Chaung
- Department of Nursing, Semyung University, Jecheon, South Korea
| | - J S Won
- College of Nursing, Eulji University, Sungnam, South Korea
| | - M-J Choi
- College of Nursing, The Catholic University of Korea, Seoul, South Korea.
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Zhang S, Kong X, Lamb KV, Wu Y. High nursing workload is a main associated factor of poor hand hygiene adherence in Beijing, China: An observational study. Int J Nurs Pract 2019; 25:e12720. [PMID: 30609173 DOI: 10.1111/ijn.12720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 11/20/2018] [Accepted: 11/24/2018] [Indexed: 11/27/2022]
Abstract
AIM The aim of the study was to explore the impact of nurse workloads on adherence to hand hygiene. BACKGROUND Adherence to hand hygiene and nursing workloads have been linked to quality of patient care. Therefore, it was important to understand the relationship to safe patient care. DESIGN This cross-sectional study was performed from January 2016 to June 2016. METHODS Workloads and adherence to hand hygiene for nurses on 3-day shifts in a tertiary hospital were investigated in 2016. Actual hours worked per shift were timed using a stopwatch to assess nursing workloads. Descriptive and inferential statistics and multiple variable regression analysis were used to analyse the data. RESULTS Sixty-four nurses from four wards were observed. The average adherence rate of hand hygiene was 26.6% and the average nursing workload per shift was 6.7 hours. Multiple regression revealed that nursing workload was negatively related to adherence rate of hand hygiene. CONCLUSION Nurses in this study that had a low rate of adherence with hand hygiene frequently had high workloads. Adherence to hand hygiene was independently associated with actual hours worked per shift.
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Affiliation(s)
- Shan Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Xiangping Kong
- Teaching Administration, Beijing Chaoyang Hospital, Beijing, China
| | - Karen V Lamb
- College of Nursing, Rush University, Chicago, Illinois, USA
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing, China
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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] [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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Mahomed S, Sturm AW, Knight S, Moodley P. An evaluation of infection control in private and public sector intensive care units in South Africa. J Infect Prev 2017; 19:87-93. [PMID: 29552099 DOI: 10.1177/1757177417733061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/30/2017] [Indexed: 11/15/2022] Open
Abstract
Background Appropriate infection control policies and practices are key to reducing the risk of healthcare-associated infections in patients in intensive care units (ICUs). Objective To evaluate infection control in ICUs using the Infection Control Assessment Tool (ICAT). Methods Six public and five private adult ICUs were included. Seven modules from the ICAT were administered including ICU, hand hygiene, and isolation and standard precautions. Modules were scored on a quantitative scale as per the tool guidelines and trained independent nurses observed practices. Results All ICUs reported to have a 1:1 nurse-to-patient ratio. One public ICU did not have the required 1:2 hand wash basin-to-bed ratio. We observed 100% adherence to handwashing or alcohol rub at each of the five moments of hand hygiene; however, the correct amount of alcohol rub was used in only 2% (n = 2) of the 117 observations. The median score for isolation and standard precautions was 79%. Discussion There was good infection control practice in ICUs. However, ICUs did not have isolation policies for all the infections listed in the ICAT and did not screen visitors to the ICU. We identified shortcomings in the ICAT and a more suitable tool is required for our healthcare setting.
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Affiliation(s)
- Saajida Mahomed
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - A Willem Sturm
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Stephen Knight
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Prashini Moodley
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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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] [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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Okunishi J, Nagahara H, Tsujitani K, Matsuse H, Kugawa K, Soga M. Usability of an Alcohol Disinfectant Containing Organic Acids and Metal Salt for Environmental Surfaces. YAKUGAKU ZASSHI 2016; 136:1233-42. [PMID: 27301389 DOI: 10.1248/yakushi.16-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Environmental cleaning and disinfection plays an important role as a part of the standard precautions to prevent healthcare-associated infections, whereas hand hygiene is one of the most important strategies for breaking the chain of transmission. Cleaning and disinfection of high-touch areas in a health-care facility is emphasized. And wiping with an alcohol-saturated cloth which has features such as low corrosion and a wide range of antimicrobial activity is performed commonly for this purpose. Although alcohol provides immediate activity against enveloped viruses, its virucidal activity against certain non-enveloped viruses, including norovirus, is insufficient. We created a novel alcohol-based hand rub, MR06B7, which is safe for the skin, and is active against an extended spectrum of microorganisms including non-enveloped viruses. For environmental surface disinfection, a novel disinfectant MR13B15, which is based on MR06B7, has been developed. In vitro antimicrobial activity against a variety of pathogens, material compatibility, and simulated surface disinfection and decontamination efficacy of MR13B15 were investigated. According to the results, MR13B15 demonstrated potent bactericidal, fungicidal, mycobactericidal, and virucidal activity within a short contact time in addition to superior efficacy against non-enveloped viruses compared to ethanol for disinfection. Moreover, MR13B15 showed better material compatibility. Two simulation tests conducted for evaluating the disinfection and decontamination potency on environmental surfaces against feline calicivirus, a surrogate for norovirus, indicated that MR13B15 had superior efficacy for surface treatment compared to ethanol. These findings suggest that MR13B15, which satisfies most requirements of an environmental surface disinfectant, may contribute to accomplishing advanced standard precautions in preventing infections.
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Affiliation(s)
- Junji Okunishi
- Maruishi Pharmaceutical Co., Ltd., Pharmaceutical Research and Develop Division
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Sakihama T, Honda H, Saint S, Fowler KE, Kamiya T, Sato Y, Iuchi R, Tokuda Y. Improving healthcare worker hand hygiene adherence before patient contact: A multimodal intervention of hand hygiene practice in Three Japanese tertiary care centers. J Hosp Med 2016; 11:199-205. [PMID: 26427035 DOI: 10.1002/jhm.2491] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 07/15/2015] [Accepted: 08/05/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Though hand hygiene is an important method of preventing healthcare-associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%-25%). OBJECTIVE Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. SETTING A total of 3 to 4 inpatient wards in 3 Japanese hospitals. DESIGN Pre-post intervention study. INTERVENTION The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. MEASUREMENT We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre-intervention adherence rates. RESULTS We observed 2982 postintervention provider-patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre- to 33% postintervention; P < 0.001), but postintervention adherence rates varied considerably: hospital A + 29%, B + 5%, C + 8%. Hospital A won the contest with 40% adherence after the intervention. CONCLUSIONS Using a novel contest coupled with a multimodal intervention successfully improved hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary.
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Affiliation(s)
- Tomoko Sakihama
- Department of Nursing, International University of Health and Welfare Graduate School, Minato-ku, Tokyo, Japan
| | - Hitoshi Honda
- Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Sanjay Saint
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Toru Kamiya
- Division of General Internal Medicine & Infectious Diseases, Rakuwakai Otowa Hospital, Yamashina, Kyoto, Japan
| | - Yumiko Sato
- Division of Infection Control, Teine Keijinkai Medical Center, Sapporo, Hokkaido, Japan
| | - Ritsuko Iuchi
- Division of Infection Control, Rakuwakai Otowa Hospital, Yamashina, Kyoto, Japan
| | - Yasuharu Tokuda
- Japan Community Healthcare Organization, Minato-ku, Tokyo, Japan
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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] [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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Introducing the No Preventable Harms campaign: creating the safest health care system in the world, starting with catheter-associated urinary tract infection prevention. Am J Infect Control 2015; 43:254-9. [PMID: 25728151 DOI: 10.1016/j.ajic.2014.11.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Endemic health care-associated safety problems, including health care-associated infection, account for substantial morbidity and mortality. We outline a regional No Preventable Harms campaign to reduce these safety problems and describe the initial results from the first initiative focusing on catheter-associated urinary tract infection (CAUTI) prevention. METHODS We formed a think tank composed of multidisciplinary experts from within a 7-hospital Midwestern Veterans Affairs network to identify hospital-acquired conditions that had strong evidence on how to prevent the harm and outcome data that could be easily collected to evaluate improvement efforts. The first initiative of this campaign focused on CAUTI prevention. Quantitative data on CAUTI rates and qualitative data from site visit interviews were used to evaluate the initiative. RESULTS Quantitative data showed a significant reduction in CAUTI rates per 1,000 catheter days for nonintensive care units across the region (2.4 preinitiative and 0.8 postinitiative; P = .001), but no improvement in the intensive care unit rate (1.4 preinitiative and 2.1 postinitiative; P = .16). Themes that emerged from our qualitative data highlight the need for considering local context and the importance of communication when developing and implementing regional initiatives. CONCLUSIONS A regional collaborative can be a valuable strategy for addressing important endemic patient safety problems.
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