Adherence to hand hygiene in critical sectors: Can we go on like this?

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.

Infection control Knowledge, Practices, and Perceived barriers towards COVID-19 among physicians in university hospitals, Cairo, Egypt.

“…In our study, the most prevalent correct practice was related to hand washing as only 5% of our participants rarely apply proper hand washing, while 58.5% of them always apply it properly. This is higher than that has been found in a study conducted in Brazil as the hand washing adherence rate was 46.25% in critical care unit [31] About 58.5.5% of the studied group always wears PPE, while only 8.2% rarely wears it properly and 23% always Uses N95 mask during all patient management procedures, this is in line with a study conducted in Saudi Arabia which has reported that 71% of health workers wear the mask during work [32]. Another study that has been carried out in Pakistan has shown that the correct usage of masks was good in 35.2%, moderate in 45.4%, and poor in 19.3% of the studied group [33].In contrast, a study has been carried out in Vietnam has reported that there is a limited number of correct responses regarding items related to the use of personal protective equipment [34].…”

Clinical Factors, Preventive Behaviours and Temporal Outcomes Associated with COVID-19 Infection in Health Professionals at a Spanish Hospital

“…Although it has been suggested that correct hand hygiene practices are not widely followed by health professionals (46.3% rate of adherence) [18], our results suggest that professionals at our hospital are more aware of preventive hand hygiene measures than the correct use of masks. Nevertheless, self-use of masks when respiratory symptoms (coughing, sneezing) are present, and the use of masks from the moment of first contact for patients with the same symptoms have been classically considered universal or standard precautions [19].…”

COVID‐19 reinforces the importance of handwashing

“…As nurses, we are aware that handwashing has not always been taken as seriously as it should, with compliance and adherence in clinical settings far from optimal over time (Bezerra et al, 2020;Pittet, 2001). Multiple reports from different countries have shown that hand hygiene compliance rate has been estimated at only 40% (Erasmus et al, 2010) while the rate of adherence in critical care units was only 46.25% (Bezerra et al, 2020). Although this is a simple and lifesaving task, it is not, regrettably, always undertaken (Doronina, Jones, Martello, Biron, & Lavoie-Tremblay, 2017).…”