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Valim MD, Rossetto JR, Bortolini J, Herwaldt L. Hand hygiene compliance in a Brazilian COVID-19 unit: the impact of moments and contact precautions. Antimicrob Resist Infect Control 2024; 13:7. [PMID: 38254156 PMCID: PMC10801978 DOI: 10.1186/s13756-023-01356-3] [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: 08/25/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Healthcare-associated infections are among the most common complications during hospitalization. These infections increase morbidity and mortality and they increase length of hospital stay and the cost of healthcare. The aims of our study were to monitor hand hygiene (HH) compliance, HH technique quality and factors related to HH practice among health professionals in a COVID-19 Intensive Care Unit (ICU). METHODS An observational, prospective study. Between September and December 2021, we observed 69 healthcare professionals in an eight-bed ICU for patients with COVID-19 in midwestern Brazil. We used the WHO observation form to collect data. The dependent variable was HH compliance and independent variables were professional category, sex, HH quality (3-step technique for at least 15 s), number of HH opportunities observed, observation shift and inappropriate glove use. RESULTS We observed 1185 HH opportunities. The overall compliance rate was 26.4%, but only 6.5% were performed with the correct 3-step technique for the minimum time. HH compliance was considerably lower for moments "before" tasks (6.7%; 95% CI 4.8%, 9.2%) compared with moments "after" tasks (43.8%; 95% CI 39.9%, 47.8%). The logistic model found that inappropriate glove use, night shift and physicians (p < 0.001) were associated with low HH compliance. The infrastructure analysis found that the unit had an insufficient number of alcohol-based handrub (ABHR) dispensers at the point of care and that the mechanism for activating them was poorly designed. CONCLUSIONS HH compliance was very low. Inappropriate glove use was associated with low compliance and the unit's infrastructure did not support good HH practice. The fact that healthcare professionals were more likely to do HH after tasks, suggests that they use HH to protect themselves rather than the patients. Adequate infrastructure and ongoing health education with a focus on HH while caring for patients in contact precautions are essential for improving HH compliance and patient safety.
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Affiliation(s)
- Marília Duarte Valim
- Nursing Department, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
| | | | - Juliano Bortolini
- Statistics Department, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Loreen Herwaldt
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Karahan Okuroğlu G, Kaynar Şimşek A, Pazar N, Ecevit Alpar Ş. The Effect of Video-Assisted Training and Visual Feedback With UV Germ Technology on Nursing Students' Hand Hygiene Beliefs, Practices, and Compliance: A Randomized Controlled Study. J Nurs Care Qual 2023; 38:335-340. [PMID: 36947854 DOI: 10.1097/ncq.0000000000000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Hand hygiene (HH) is the most effective way to prevent health care-associated infections; however, HH compliance rates continue to be suboptimal. PURPOSE To determine the effectiveness of video-assisted training and visual feedback with ultraviolet (UV) germ technology on nursing students' HH beliefs, practices, and compliance. METHODS This study used a double-blind, posttest randomized controlled design. The experimental group received training, visual feedback with UV germ technology, and instructional videos. RESULTS A total of 46 students were included in the study (experimental 21 and control 25). The mean score of the HH skills checklist of the experimental group was significantly higher than that of the control group ( P = .0001). The HH compliance rate was also higher in the experimental group (52.62%) compared with the control group (39.1%). CONCLUSIONS The training, visual feedback with UV germ technology, and instructional videos increased HH compliance rates in nursing students.
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Affiliation(s)
- Gülten Karahan Okuroğlu
- Department of Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey (Drs Karahan Okuroğlu, Kaynar Şimşek and Ecevit Alpar); and Marmara University Pendik Education and Research Hospital, Istanbul, Turkey (Ms Pazar)
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Ragonese B, Mularoni A, Valeri A, Campanella M, Corso B, Fazzina ML, Barone MA, Arena G, Lombardo R, Luca A. Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool: A Quality Improvement Project. J Nurs Care Qual 2023; 38:47-54. [PMID: 36066885 DOI: 10.1097/ncq.0000000000000651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide urgent health problem. Hand hygiene (HH) is an effective intervention to reduce the spread of CRE. LOCAL PROBLEM In 2017, an increase in the rate of health care-associated (HA) CRE colonization was observed in a large multiorgan transplant center in Italy. This study aimed to reduce the HA-CRE colonization rates by improving HH compliance. METHODS A pre-/post-intervention project was conducted from November 2017 through December 2020. INTERVENTIONS The DMAIC (Define, Measure, Analyze, Improve, and Control) framework was used to implement the HH Targeted Solution Tool (TST). RESULTS Hand hygiene compliance increased from 49% to 76.9% after the Improve phase ( P = .0001), and to 81.9% after the second Control phase ( P = .0001). The rate of HA-CRE decreased from 24.9% to 5.6% ( P = .0001). CONCLUSIONS Using the DMAIC framework to implement the TST can result in significant improvements in HH compliance and HA-CRE colonization rates.
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Affiliation(s)
- Barbara Ragonese
- Quality and Accreditation Department (Mss Ragonese, Corso, Fazzina, and Barone), Department of Infectious Diseases (Dr Mularoni), and Department of Diagnostic and Therapeutic Services (Dr Luca), Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy; Quality and Accreditation Department, University of Pittsburgh Medical Centre (UPMC), Rome, Italy (Mr Valeri); Infection Control and Infectious Diseases, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy (Ms Campanella); and Corporate Nursing, Technical, and Rehabilitation Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy (Messrs Arena and Lombardo)
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Zheng S, Yang Q, Wang X, Zhang X, Zhou Q. Capability, Opportunity, Motivation, and Hand Hygiene Behavior in Healthcare Workers: A Structural Equation Modeling. Psychol Res Behav Manag 2022; 15:2219-2228. [PMID: 36003832 PMCID: PMC9393114 DOI: 10.2147/prbm.s373287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Hand hygiene among healthcare workers is the leading measure to reduce healthcare-associated infections. However, hand hygiene behavior is complex and not readily understood. This study aimed to identify the determinants and the underlying mechanism of hand hygiene behavior based on the capability, opportunity, motivation-behavior model. Methods A self-constructed questionnaire survey was conducted among healthcare workers in Chongqing, China. Capability, opportunity, and motivation were designed as independent variables, and hand hygiene behavior was measured as a dependent variable. Internal consistency reliability analysis and confirmatory factor analysis were applied to examine the reliability and validity of the questionnaire. Structural equation modeling was performed to explore the relationships among capability, opportunity, motivation, and hand hygiene behavior. Results Four hundred and ninety-nine physicians and nurses were investigated. The Cronbach’s α coefficients were above 0.764. Confirmatory factor analysis was confirmed with good data fitness. The structural equation modeling had a good fit (root mean square error of approximation=0.070, comparative fit index=0.960, Tucker–Lewis index=0.956). Both opportunity (β=0.265, p<0.05) and motivation (β=0.333, p<0.05) directly affected hand hygiene behavior. Both capability (β=0.194, p<0.001) and opportunity (β=0.719, p<0.001) were indirectly linked to hand hygiene behavior through motivation. Conclusion To improve hand hygiene behavior, more efforts need to be focused on resource provision and motivation enhancement in the future compared to training.
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Affiliation(s)
- Shuangjiang Zheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.,Department of Medical Affairs, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Qiuxia Yang
- Administration Department, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, People's Republic of China
| | - Xuemei Wang
- Administration Department, Nanjing Drum Tower Hospital, Nanjing, People's Republic of China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qian Zhou
- Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Baggio É, Cadore Weis M, da Silva Santos B, Mccabe C, Neill F, Duarte Valim M. Brazilian Mobile Phone Applications Related to Hand Hygiene and Their Applicability for Healthcare Professionals. Comput Inform Nurs 2021; 40:208-218. [PMID: 34570006 DOI: 10.1097/cin.0000000000000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to identify available mobile applications regarding education for hand hygiene and their applicability as a resource for nurses and other healthcare professionals. The aim was to assess the quality of the mobile apps for education on hand hygiene for health professionals. A review of mobile apps available from Apple App Store and Google Play Store in Brazil was conducted. The World Health Organization recommendations and the Mobile Application Rating Scale for evaluating quality were used. Six applications were selected, only three presented gamification elements incorporated into the learning method and only two of them-SureWash Pocket and Give Me 5-used the international recommendations to improve hand hygiene compliance in a more substantial and interactive way. The mean quality total score for the five rated apps was 3.41, indicating poor to acceptable quality. SureWash Pocket was the only application that reached Mobile Application Rating Scale ≥4 in all dimensions. These mobile applications can be used as complementary alternatives in addition to other available education strategies to improve the standards of hand hygiene and change the behavior of health professionals.
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Affiliation(s)
- Érica Baggio
- Author Affiliations: Nursing Graduate Program (Ms Baggio), Nursing Department (Ms Cadore Weis), and Nursing Graduate Program (Mr da Silva Santos), Federal University of Mato Grosso, Cuiabá, Brazil; General Nurse (Dr Mccabe) and Clinical Skills (Dr Neill), School of Nursing and Midwifery, Dublin, Dublin, Ireland; and Nursing Department, Federal University of Mato Grosso, Cuiabá, Brazil (Dr Duarte Valim)
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Abstract
PURPOSE OF REVIEW Healthcare-associated infections (HAIs) challenge healthcare systems worldwide. As healthcare workers' hands are considered the main vector for transmission of pathogens, effective hand hygiene is the single most important action to prevent HAIs. We sought to highlight new developments and advances in hand hygiene. RECENT FINDINGS Hand hygiene compliance averages at 38%. A sustained increase of compliance with a subsequent decrease of HAIs may be achieved by national, systematic and rigorous education, and auditing programs. Periodically deployed self-operating hand hygiene surveillance systems coupled with personalized reminders could facilitate such efforts. Alcohol-based hand-rub (ABHR) solutions remain the hand hygiene gold standard, but are modified in texture and composition to better meet healthcare workers' preferences. Modifications of the hand hygiene procedure have been proposed targeting both time and technique of hand rub application. Reducing rub-time from 30 to 15 s and simplifying the technique to consist of three rather than six steps yielded encouraging results in terms of microbiological efficacy and higher compliance. SUMMARY Implementation and promotion of compliance are the major concerns of today's research on hand hygiene. Developments towards better surveillance and systematic education, improved ABHR formulation and streamlining of hand hygiene actions are paving the way ahead.
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Vargas-Porras C, Roa-Díaz ZM, Hernández-Hincapié HG, Ferré-Grau C, de Molina-Fernández MI. Efficacy of a multimodal nursing intervention strategy in the process of becoming a mother: A randomized controlled trial. Res Nurs Health 2021; 44:424-437. [PMID: 33682146 DOI: 10.1002/nur.22123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 02/01/2021] [Accepted: 02/20/2021] [Indexed: 11/05/2022]
Abstract
The lack of knowledge and skills for transitioning to motherhood places first-time mothers at greater risk of depression and stress, may lower their perceived self-efficacy and satisfaction with the maternal role, and potentially affects the mother-infant bond. The purpose of this study was to test the efficacy of a multimodal nursing intervention (AMACOMPRI), based on Mercer's Becoming a Mother Theory, in supporting the process of becoming a mother in first-time mothers of term infants. This study was a parallel-group, double-blind, randomized, controlled trial with a 4-month postpartum follow-up. The outcome measures were the process of becoming a mother, functional social support, mother-infant bond, and perceived maternal self-efficacy. Sixty-six first-time mothers completed the study: 33 in the intervention group and 33 in the control group. The intervention was effective in supporting the process of becoming a mother, with a large effect size (Cohen's d = 1.50) and higher scores on the Becoming-a-Mother Scale in the intervention group compared with the control group (intergroup difference 13.04 points; 95% confidence interval: 8.72-17.34). Participants in the intervention group demonstrated higher scores in functional social support, perceived maternal self-efficacy, and mother-infant bond. This study provides evidence for the efficacy of an innovative nursing intervention that supports the process of becoming a mother. Further testing of the intervention is required in different settings and first-time mothers of low and high risk newborns.
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Affiliation(s)
- Carolina Vargas-Porras
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.,Faculty of Health, School of Nursing, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - Zayne M Roa-Díaz
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Carme Ferré-Grau
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - María I de Molina-Fernández
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
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Batista J, Silva DPD, Nazário SDS, Cruz EDDA. Multimodal strategy for hand hygiene in field hospitals of COVID-19. Rev Bras Enferm 2020; 73:e20200487. [PMID: 33111781 DOI: 10.1590/0034-7167-2020-0487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/22/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Reflect and propose adaptations to the Multimodal Hand Hygiene Strategy for field hospitals, in the context of the COVID-19 pandemic. METHOD Reflective study, carried out in April 2020, based on the recommendations of the World Health Organization and the guide for the implementation of the five components of the Multimodal Strategy: system change related to infrastructure; training/education; evaluation and feedback; reminders in the workplace; and institutional security climate. RESULTS The Multimodal Strategy, proposed for hospitals in general, can be adapted for field hospitals in order to reduce the transmission of the SARS-CoV-2 virus. Investments to adapt the infrastructure and education of workers require foresight and speed and are of special relevance to promote hand hygiene in this care context. FINAL CONSIDERATIONS Adjusting the Multimodal Strategy, especially for the reduced time in the execution of each component, is necessary for field hospitals with a view to preventing COVID-19.
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Salcedo-Cifuentes M, Ordóñez-Hernández CA, Calvo-Soto AP. Cumplimiento de una estrategia de higiene de las manos en ambientes asistenciales. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2020. [DOI: 10.11144/javeriana.ie22.cehm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introducción: Si bien la higiene de las manos es la medida más importante en la mitigación del riesgo biológico en ambientes hospitalarios, evidencia científica muestra un escaso cumplimiento de las recomendaciones entre los trabajadores asistenciales. Objetivo: Evaluar el cumplimiento de cinco dimensiones que fortalecen la estrategia de higiene de las manos para la prevención del riesgo biológico en ambientes asistenciales. Método: Estudio observacional, de corte transversal, en cinco instituciones prestadoras de servicios de salud. Se aplicó estadística descriptiva. Con el Test de Medianas se evaluó si había diferencias significativas entre el grupo de profesionales por institución de salud, considerando significante una p ≤ 0,05. El análisis finalizó con un análisis discriminante. Resultados: La representatividad estuvo en las instituciones hospitalarias de primer nivel en las cuales el personal de enfermería, seguido por los médicos, tuvo un mejor cumplimiento del protocolo de lavado de manos. Este porcentaje se vio impactado por el menor cumplimiento de suministro de insumos e infraestructura. Hay una perfecta diferenciación entre los resultados del municipio de Cali con relación al de Caicedonia, en contraste con los de Popayán, Buga y Buenaventura. Conclusión: Se encontró un incumplimiento del protocolo de higiene de las manos, con una calificación inaceptable para los factores de insumos/infraestructura y técnica de higiene de las manos, respectivamente.
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Oliveira BADS, Bernardes LDO, Ferreira AM, Pessalacia JDR, Furlan MCR, de Sousa ÁFL, de Andrade D, Barbosa DA, Lapão LV, dos Santos Junior AG. Impact of Educational Intervention on Cleaning and Disinfection of an Emergency Unit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093313. [PMID: 32397527 PMCID: PMC7246614 DOI: 10.3390/ijerph17093313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Abstract
We aimed to evaluate the impact of an educational intervention on the surface cleaning and disinfection of an emergency room. This is an interventional, prospective, longitudinal, analytical and comparative study. Data collection consisted of three stages (Stage 1-baseline, Stage 2-intervention and immediate assessment, Stage 3-long term assessment). For the statistical analysis, we used a significance level of α = 0.05. The Wilcoxon and the Mann-Whitney test tests were applied. We performed 192 assessments in each stage totaling 576 evaluations. Considering the ATP method, the percentage of approval increased after the educational intervention, as the approval rate for ATP was 25% (Stage 1), immediately after the intervention it went to 100% of the approval (Stage 2), and in the long run, 75% of the areas have been fully approved. Stage 1 showed the existence of significant differences between the relative light units (RLU) scores on only two surfaces assessed: dressing cart (p = 0.021) and women's toilet flush handle (p = 0.014); Stage 2 presented three results with significant differences for ATP: dressing cart (p = 0.014), women's restroom door handle (p = 0.014) and women's toilet flush handle (p = 0.014); in step III, there was no significant difference for the ATP method. Therefore, conclusively, the educational intervention had a positive result in the short term for ATP; however, the same rates are not observed with the colony-forming units (CFU), due to their high sensitivity and the visual inspection method since four surfaces had defects in their structure.
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Affiliation(s)
- Bruna Andrade dos Santos Oliveira
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Lucas de Oliveira Bernardes
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Adriano Menis Ferreira
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Juliana Dias Reis Pessalacia
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Mara Cristina Ribeiro Furlan
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
| | - Álvaro Francisco Lopes de Sousa
- Network in Exposome Human and Infectious Diseases (NEHID), School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
- Correspondence:
| | - Denise de Andrade
- Network in Exposome Human and Infectious Diseases (NEHID), School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
| | | | - Luis Velez Lapão
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
| | - Aires Garcia dos Santos Junior
- Campus Três Lagoas, University of Mato Grosso do Sul, Três Lagoas 79600-080, Brazil; (B.A.d.S.O.); (L.d.O.B.); (A.M.F.); (J.D.R.P.); (M.C.R.F.); (A.G.d.S.J.)
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Irehovbude J, Okoye CA. Hand hygiene compliance: bridging the awareness-practice gap in sub-Saharan Africa. GMS HYGIENE AND INFECTION CONTROL 2020; 15:Doc06. [PMID: 32547906 PMCID: PMC7273322 DOI: 10.3205/dgkh000341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review provides an exploratory overview of hand hygiene compliance in sub-Saharan Africa and examines strategies to bridge the compliance gap. While there is increasing awareness on hand hygiene, empirical evidence suggests that there is no concurrent increase in correct hand hygiene practice among key populations in sub-Saharan Africa. Children, adolescents and even healthcare providers (HCPs) in sub-Saharan Africa consistently assume poor hand hygiene compliance levels resulting in negative health consequences. Faecal-oral diseases remain common among schoolchildren, leading to school absenteeism and disease-specific morbidity. Additionally, the incidence of nosocomial infections in health facilities in sub-Saharan Africa remains high, as many HCPs do not adopt good hand hygiene practice. Increased disease burden, high healthcare costs and eroding public confidence in the healthcare system are a few implications of HCPs’ poor compliance with hand hygiene. These trends underscore the inadequacies of educational approaches (cognition model) to hand hygiene promotion commonly adopted in sub-Saharan Africa. It was therefore recommended that the governments of sub-Saharan Africa should focus on promoting skill-based hygiene education which will help schoolchildren develop good hand hygiene practice as a lifelong skill. In addition, efforts should be made to implement a multimodal hand hygiene strategy in healthcare facilities in order to increase compliance by healthcare providers.
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Affiliation(s)
- Jahmai Irehovbude
- Department of Human Kinetics and Health Education, Ambrose Alli University, Ekpoma, Edo State, Nigeria
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Bezerra TB, Valim MD, Bortolini J, Ribeiro RP, Marcon SR, Moura MEB. Adherence to hand hygiene in critical sectors: Can we go on like this? J Clin Nurs 2020; 29:2691-2698. [PMID: 32301162 DOI: 10.1111/jocn.15293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 03/11/2020] [Accepted: 03/23/2020] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES The rates of healthcare-associated infections are high around the world. Hand hygiene is considered the most effective measure to reduce the transmission of pathogens in the hospital environment. Our objective was to evaluate adherence to hand hygiene in critical units of a tertiary-level hospital in Central-West Brazil. DESIGN Observational study employing cross-sectional data. Reporting rigour was demonstrated using the STROBE checklist. METHODS Observation of hand hygiene practices of 129 professionals from the health team, including nursing staff, physicians and physical therapists. Data collection was carried out using the World Health Organization form. RESULTS A total of 3,025 hand hygiene opportunities were observed, and the overall rate of adherence was only 46.25%. There was a greater frequency of hand hygiene after risk of exposure to bodily fluids and after contact with patients, 60.80% and 53.45%, respectively. Nurses obtained a higher rate of adherence to hand hygiene (59.80%). The neonatal ICU had a higher rate of adherence to hand hygiene when compared to other sectors. CONCLUSIONS The physical structure for hand hygiene in the institution was poor, and no professionals reached the minimum time required for execution of hand hygiene techniques. There were low rates of adherence to hand hygiene by professionals at all five times and in all categories and sectors observed, which may have been influenced by poor infrastructure present in the institution. RELEVANCE TO CLINICAL PRACTICE This study is of great relevance to patient safety, given the rates of healthcare-associated infections worldwide, with emphasis on underdeveloped countries. It is hoped that the results of this research can guide organisations to validly and systematically evaluate adherence to hand hygiene and achieve higher rates of adherence to hand hygiene and consequently reduce the number of infections in health environments.
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Affiliation(s)
| | | | - Juliano Bortolini
- Statistics Department, Federal University of Mato Grosso, Cuiabá, Brazil
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Vale ÉDL, Cunha de Menezes LC, Bezerra INM, Frutuoso ES, Silva Gama ZAD, Wanderley VB, Piuvezam G. Melhoria da qualidade do cuidado à hipertensão gestacional em terapia intensiva. AVANCES EN ENFERMERÍA 2020. [DOI: 10.15446/av.enferm.v38n1.81081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: avaliar o efeito de um ciclo de melhoria da qualidade na implementação de práticas baseadas em evidências no tratamento de mulheres com doenças hipertensivas gestacionais admitidas em Unidade de Terapia Intensiva Materna (UTIM).Métodos: estudo quase-experimental, sem grupo de controle, realizado numa UTIM de um hospital universitário que seguiu as etapas de um ciclo de melhoria da qualidade. Avaliaram-se nove critérios de processo em todas as mulheres admitidas com diagnóstico de doenças hipertensivas gestacionais nos períodos anterior (n = 50) e posterior à intervenção (n = 50) em 2015. Estimou-se a conformidade com intervalo de confiança de 95 %, as não conformidades com gráficos de Pareto e a significância da melhoria com teste do valor Z unilateral (α = 5 %).Resultados: o nível de qualidade inicial foi alto em seis dos nove critérios (amplitude: 94-100 %), as práticas com menor adesão foram a “manutenção de sulfato de magnésio” (54 %), “solicitação de ultrassom fetal” (72 %) e “restrição hídrica intravenosa” (78 %). Houve melhoria absoluta em cinco dos nove critérios (amplitude: 2-16 %), que foi significativa para a solicitação de ultrassom fetal (melhoria absoluta: 16 %; p = 0,023) e para o total de critérios (4 %; p = 0,01).Conclusão: a intervenção de melhoria da qualidade proposta aumentou a adesão às recomendações baseadas em evidência para o tratamento de pacientes com doenças hipertensivas gestacionais admitidas em uma UTIM.
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