Hand Hygiene Compliance in a Hematology Unit

Abstract

Transmission of pathogens from the hands of health care workers (HCWs) is the main cause of nosocomial infections, and hand hygiene is the single most important procedure to prevent it. At present, little is known about the adherence of HCWs to hand hygiene procedures in hematology units, where the patients are at high risk for acquiring hospital infections. In a prospective observational study, two observers monitored the hand hygiene compliance of HCWs in a hematology unit during 30-min observation periods distributed randomly during the daytime over 2 months. The prevalence of compliance with hand hygiene was 26% on 638 observed occasions. The noncompliance was higher among nurses [odds ratio (OR) 3.52, 95% confidence interval (CI) 1.85–6.70] and other HCWs (OR 1.72, 95% CI 0.98–3.02) compared to physicians. The compliance rate differed from 4 to 60% depending on the activity. The lowest compliance rate (4%) was observed before patient care and the highest (60%) was after insertion of invasive devices. When we classified the occasions for hand hygiene into ‘before’ and ‘after’ activities, the compliance rates were 9 and 36%, respectively (OR 5.6, 95% CI 3.4–9.0). In conclusion, noncompliance with hand hygiene was high in this hematology unit, especially among nurses and before activities. Variations with the type of HCW and activity suggest that targeted educational programs and feedback control may be useful.

Higienização De Mãos: 20 Anos De Divergências Entre a Prática E O Idealizado

“…Ao serem indagados sobre o problema, os profissionais afirmaram ser possível aumentar a adesão à hM (11,12). Frente às oportunidades na prá-tica assistencial, observou-se maior adesão dos profissionais à hM após executarem o cuidado e contato com fluidos corporais em detrimento à etapa antes do contato, revelando-se mais como uma prática de autocuidado que de cuidado ao paciente (13)(14)(15).…”

“…Pesquisas demonstraram que quanto maior a gravidade do paciente, mais frequentes foram as oportunidades para hM e menor a adesão a essa prática (12), inclusive em pacientes hematológicos, os quais são mais suscetíveis às infecções (15). Nas investigações de surtos de infecção verificou-se estreita relação entre a sobrecarga de trabalho e falhas nas medidas de prevenção (16).…”

Exploring the influence of enforcing infection control directives on the risk of developing healthcare associated infections in the intensive care unit: A retrospective study

“…The current rate of 10-60% compliance (Korniewicz and El-Masri, 2010;Maskerine and Loeb, 2006) with hand hygiene guidelines and the incidence of HAIs in one of every nine Canadian hospital admissions (CFID, 2008) are unacceptable and must be addressed. For instance, the literature suggests that HCPs report higher compliance rate with hand hygiene after procedures than before procedures (Korniewicz and El-Masri, 2010;Saba et al, 2005), which may suggest that HCPs are more likely to sanitise their hands out of fear for their own health than that of their patients. Although we did not measure HCPs adherence to hand hygiene in our study, anecdotal data suggest that HCPs were strictly complying with infection control guidelines (including hand hygiene) due to institutional enforcement of these guidelines and internal motivation that was driven by fear for one's own health.…”

“…Although HCPs are expected to demonstrate full adherence with these guidelines, the literature suggests that adherence with infection control guidelines are less than optimal. For instance, several studies have shown that hand hygiene compliance amongst HCPs ranges from 10 to 60% (Arenas et al, 2005;Korniewicz and El-Masri, 2010;Lankford et al, 2003;Larson et al, 2005;Saba et al, 2005;Whitby and McLaws, 2004). These statistics are especially concerning in light of the costly consequences of healthcare associated infections (HAIs) to patients and the health care system.…”

Avaliação do impacto de medidas de intervenção em unidades de terapia intensiva do estado de São Paulo

“…Além disso, apesar de ser a medida mais importante para a prevenção de transmissão de IRAS, a higiene das mãos é muitas vezes negligenciada pelos profissionais de saúde em serviços com recursos limitados, com adesão inferior a 20% em vários trabalhos [3][4][5][6][7][8][9][10][11] .…”