Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Oyibo, PG; Nwakpu, Kingsley Onuoha; Nnabu, Richard Chukwuka; Prasopa-Plaizier, Nittita

doi:10.1016/j.bjid.2013.04.006

Cited by 52 publications

(78 citation statements)

References 28 publications

(34 reference statements)

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“…Higher rates were reported in Saudi Arabia (50.3%), southwest Nigeria (55%) and southeast Nigeria (65.3%) Fig. 3 Compliance with hand hygiene by healthcare worker category in a tertiary hospital, Nigeria [37][38][39]. The high compliance rate observed in the Southeastern and Southwestern Nigerian studies may be attributed to the positive effect of the interventional programs mentioned in the studies which included systematic HH training, and the use of HH posters and other reminders in the hospital facilities.…”

Section: Discussionmentioning

confidence: 99%

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

Onyedibe

Shehu

Pires

et al. 2020

Antimicrob Resist Infect Control

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Background: The burden of healthcare-associated infection (HAI) is 2 to 18 times higher in developing countries. However, few data are available regarding infection prevention and control (IPC) process indicators in these countries. We evaluated hand hygiene (HH) facilities and compliance amongst healthcare workers (HCW) in a 600bed healthcare facility in Northcentral Nigeria providing tertiary care service for a catchment population of about 20 million. Methods: An in-house facility assessment tool and the World Health Organization (WHO) direct observation method were used to assess the HH facilities and compliance, respectively. Factors associated with good compliance were determined by multivariate analysis. Results: The facility survey was carried out in all 46 clinical units of the hospital. 72% of the units had no poster or written policy on HH; 87% did not have alcohol-based hand rubs; 98% had at least one handwash sink; 28% had flowing tap water all day while 72% utilized cup and bucket; and 58% had no hand drying facilities. A total of 406 HH opportunities were observed among 175 HCWs. The overall compliance was 31%, ranging from 18% among ward attendants to 82% among medical students. Based on WHO "5 moments" for HH, average compliance was 21% before patient contact, 23% before aseptic procedure, 63% after body fluid exposure risk, 41% after patient contact and 40% after contact with patients' surrounding. Being a medical student was independently associated with high HH compliance, adjusted odds ratio: 13.87 (1.70-112.88). Conclusions: Availability of HH facilities and HCW compliance in a large tertiary hospital in Nigeria is poor. Our findings confirm that HCWs seem more sensitized to their risk of exposure to potential pathogens than to the prevention of HAI cross-transmission. Inadequate HH facilities probably contributed to the poor compliance. Specific measures such as improved facilities, training and monitoring are needed to improve HH compliance.

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Section: Discussionmentioning

confidence: 99%

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

Onyedibe

Shehu

Pires

et al. 2020

Antimicrob Resist Infect Control

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“…Several factors have been shown to be related to low compliance with hand hygiene in developed countries [9]. In low-income countries the major reason for non-compliance with hand hygiene may be lack of adequate facilities [10]. The burden of health-care associated infections (HAIs) is high in developing countries [11].…”

Section: Introductionmentioning

confidence: 99%

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Pfäfflin

Tufa

Getachew

et al. 2017

Antimicrob Resist Infect Control

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BackgroundThe burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization.MethodsThe study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers’ perception and knowledge about hand hygiene were assessed before and after the intervention.ResultsAt baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p < 0.001). The increase in compliance with hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p < 0.001). After the training, locally produced alcohol-based handrub was used in 98.4% of all hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11–15) at baseline and increased to 17 (15–18) after training (p < 0.001). Health-care workers’ perception surveys revealed high appreciation of the different strategy components.ConclusionPromotion of hand hygiene is feasible and sustainable in a resource-constrained setting using a multimodal improvement strategy. However, absolute compliance remained low. Strong and long-term commitment by hospital management and health-care workers may be needed for further improvement.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-016-0165-9) contains supplementary material, which is available to authorized users.

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“…Um estudo (16) desenvolvido na Nigéria teve como objetivo treinar 202 trabalhadores em saúde para a higiene correta das mãos. Após o treinamento, os autores constaram adesão de 75,3% na LM, principalmente, após o contato com fluidos corporais (75,3%) e após tocar no paciente (73,6%).…”

Section: Capacitação Do Enfermeirounclassified

Aplicabilidade De Inovações E Tecnologias Assistenciais Para a Segurança Do Paciente: Revisão Integrativa

Cestari

Ferreira²,

Garcês³

et al. 2017

Cogitare Enferm.

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RESUMO: Objetivou-se identificar as tecnologias utilizadas pelo enfermeiro para promoção da segurança do paciente no contexto hospitalar. Revisão integrativa, com busca de artigos em bases de dados na área da saúde, no período de janeiro a fevereiro de 2016. Foram selecionados 20 artigos, divididos segundo as tecnologias assistenciais utilizadas. No intuito de promover a segurança do paciente, os enfermeiros utilizam tecnologias duras -implantação de registros eletrônicos, bombas de infusão, sensores e sistemas computadorizados e de alerta; incorporam as boas práticas em saúde -construção de instrumentos voltados para segurança do paciente e identificação de riscos; e realizam/participam de cursos de capacitação profissional -cálculo e administração de medicamentos e infusões intravenosas e higienização das mãos. Conclui-se que o enfermeiro é um profissional que tem se preocupado com a segurança do paciente, o que reforça a necessidade da realização de mais estudos que tenham como foco a utilização de estratégias que promovam tal prática. DESCRITORES: Segurança do paciente; Enfermagem; Tecnologia biomédica; Assistência à saúde; Capacitação em serviço. APLICABILIDADE DE INOVAÇÕES E TECNOLOGIAS ASSISTENCIAIS APPLICABILITY OF ASSISTIVE INNOVATIONS AND TECHNOLOGIES FOR PATIENT SAFETY: INTEGRATIVE REVIEWABSTRACT: The present study aimed to identify the technologies used by nurses to promote patient safety in hospital settings. Integrative review, with search of articles in databases in the health area, from January to February, 2016. Twenty articles were selected and sorted according to the assistive technologies used. In the promotion of patient safety, nurses use hard technologiesimplementation of electronic records, automated drug infusion pumps, sensors and computer-based monitoring systems. They also incorporate good practices in health -construction of instruments targeted to patient safety and identification of risks, and promote/ participate in professional training courses -calculation and administration of medications and intravenous infusions and hand hygiene. It is concluded that nursing professionals are concerned with patient safety, which reinforces the need to conduct further studies on the use of relevant strategies. RESUMEN: Estudio cuyo propósito fue identificar las tecnologías utilizadas por el enfermero para promover la seguridad del paciente en el contexto hospitalar. Revisión integrativa, con búsqueda de artículos en bases de datos en el área de la salud, en periodo de enero a febrero de 2016. Se seleccionaron 20 artículos, organizados de acuerdo a las tecnologías asistenciales utilizadas. Para promover la seguridad del paciente, los enfermeros utilizan tecnologías duras -implantación de registros electrónicos, bombas de infusión, sensores y sistemas computarizados y de alerta; añaden las buenas prácticas en salud -construcción de instrumentos para dar seguridad al paciente, así como para identificación de riesgos; y realizan/participan de cursos de capacitación profesional -cálculo y administ...

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Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities

Abstract: hand hygiene campaigns using the World Health Organization tools and methodology can be successfully executed in a tertiary health facility of a low-income setting with far reaching improvements in compliance.

Cited by 52 publications

References 28 publications

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Aplicabilidade De Inovações E Tecnologias Assistenciais Para a Segurança Do Paciente: Revisão Integrativa

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