[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to measure the degree of compliance with hand hygiene practices among health-care workers (HCWs) in intensive care facilities in Aseer Central Hospital, Abha, Saudi Arabia, before and after a multimodal intervention program based on WHO strategies. Data were collected by direct observation of HCWs while delivering routine care using standardized WHO method: “Five moments for hand hygiene approach”. Observations were conducted before (February–April 2011) and after (February–April 2013) the intervention by well-trained, infection-control practitioners during their routine visits.
The study included 1182 opportunities (observations) collected before and 2212 opportunities collected after the intervention. The overall, hand hygiene compliance increased significantly from 60.8% (95% CI: 57.9–63.6%) before the intervention to reach 86.4% (95% CI: 84.9–97.8%) post-intervention (P = 0.001). The same trend was observed in different intensive care facilities. In logistic regression analyses, HCWs were significantly more compliant (aOR = 3.2, 95% CI: 2.6–3.8) after the intervention. Similarly, being a nurse and events after patient contact were significant determinants of compliance.
It is important to provide sustained intensified training programs to help embed efficient and effective hand hygiene into all elements of care delivery. New approaches like accountability, motivation and sanctions are needed.
Journal of Epidemiology and Global Health. 01/2014;
[Show abstract][Hide abstract] ABSTRACT: Background. In 2009, the World Health Organization (WHO) recommended "My Five Moments for Hand Hygiene" (5MHH) to optimize hand hygiene (HH). Uptake of these recommendations by healthcare workers (HCWs) remains uncertain. Methods. We prospectively observed HCW compliance to 5MHH. After observations, eligible HCWs who consented to interviews completed surveys on factors associated with HH compliance based on constructs from the transtheoretical model of behavioral change (TTM) and the theory of planned behavior (TPB). Survey results were compared with observed HCW behaviors. Results. There were 968 observations among 123 HCWs, of whom 110 (89.4%) were female and 63 (51.3%) were nurses. The mean HH compliance for all 5MHH was 23.2% (95% confidence interval [CI], 18.1%-28.3%) by direct observation versus 82.4% (95% CI, 79.9%-84.9%) by self report. The HCW 5MHH compliance was associated with critical care unit encounters ([Formula: see text]), medicine unit encounters ([Formula: see text], [Formula: see text]), immunocompromised patient encounters ([Formula: see text]), and HCW prioritized patient advocacy ([Formula: see text]). Self-reported TTM stages of action or maintenance ([Formula: see text]) and the total TPB behavior score correlated with observed 5MHH ([Formula: see text], [Formula: see text]) and with self-reported 5MHH compliance ([Formula: see text], [Formula: see text]). Conclusion. Observed HCW compliance to 5MHH was associated with the type of hospital unit, type of provider-patient encounter, and theory-based behavioral measures of 5MHH commitment.
Infection Control and Hospital Epidemiology 11/2013; 34(11):1137-1145. · 4.02 Impact Factor
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