Evolution and associated factors of hand hygiene compliance in a pediatric tertiary hospital

Abstract

Background: The objective is to know the evolution of the Degree of Compliance with Recommendations (DCR) on hand hygiene (HH) and its associated factors in the pediatric care areas (PCAs) of a tertiary hospital. Methods: Observational, cross-sectional study, repeated over time, with direct observation of the DCR on HH during the daily activity of health care workers. Over 13 years, 9226 HH opportunities were observed. Associations between DCR, PCA and other variables (eg, age, sex, and professional position) were examined using x 2 and adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: DCR on HH in 9 PCAs was 64.3% (95% CI, 63.3-65.3), and in the group of non-pediatric areas it was 49.6% (95% CI, 49.1-50.1). The areas with the highest degree of compliance were Oncology 72.8% (95% CI, 69.2-76.4), Neonatology 73.2% (95% CI, 71.3-75.1), and Neonatal intensive care unit 70.0% (95% CI, 67.5-72.6). These were the areas with the strongest association with HH compliance, with aOR:2.8 (95% CI, 2.2-3.6); aOR, 3.0 (95% CI, 2.6-3.6) aOR:2.6 (95% CI, 2.1-3.1), respectively. Other associated factors were the indications "after an activity," aOR, 1.6 (95% CI, 1.5-1.8) and the availability of pocket-size alcohol-based solution, aOR, 2.1(95% CI, 1.9-2.3). Conclusions: The DCR on HH in PCAs is higher than in other areas, although there is still margin for improvement. We have identified modifiable factors that have an independent association with HH compliance in PCAs. Focusing on modifiable factors will increase compliance with HH with the ultimate goal of reducing healthcare associated infections.

Compliance with hand disinfection in the surgical area of an orthopedic university clinic: results of an observational study

“…In the present study, compliance was higher in the operation theatre for pediatric patients. Healthcare workers in pediatric patient care settings are known to have higher HH compliance [ 10 , 16 ]. One reason may be that pediatric patient populations rely greatly on hands-on-care [ 17 ].…”

Intervenciones para mejorar el grado de cumplimiento de la higiene de manos en los servicios de urgencias

“…Cabe destacar, que respecto a las oportunidades en las que se realiza la higiene de manos y considerando los 5 momentos de la OMS (1: antes de tocar al paciente, 2: antes de realizar una tarea limpia/aséptica, 3: después del riesgo de exposición a líquidos corporales, 4: después de tocar al paciente, 5: después del contacto con el entorno del paciente), existen diferencias significativas entre ellas. Hemos visto que el grado de cumplimiento es más alto en aquellas actividades que tienen lugar en los momentos "después" (3, 4 y 5 de la OMS), mientras que es menor en los momentos "antes" (1 y 2 de la OMS)(8) . Esto pone de manifiesto la necesidad de un cambio de paradigma en los profesionales sanitarios que consideran la higiene de manos como una forma de protegerse después de entrar en contacto con el paciente.…”

Strengthening Antibiotics Stewardship at Mowbray Maternity Hospital– Neonatal Unit.

“…We found that HH moment 5, after touching the patient's surroundings, showed the least overall compliance. Although we did not assess the reasons for poor compliance, studies have shown that poor compliance is affected by behavioral factors, awareness of HCWs to HH opportunity, availability of alcohol hand rubs, and overall altitude, thus emphasizing a need for continued training, use of posters and supply of appropriate alcohol at bed-side for HH [45][46][47].…”