Hand hygiene compliance in the intensive care units of a tertiary care hospital

Abstract

Context:Hand hygiene (HH) is the most important measure to prevent hospital-acquired infections but the compliance is still low.Aims:To assess the compliance, identify factors influencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW).Settings and Design:Cross-sectional study conducted in 42 bedded Medical (Pulmonary, Medicine and Stroke) intensive care units (ICU) of a tertiary care hospital.Materials and Methods:HCWs (doctors and nurses) were observed during routine patient care by observers posted in each ICU and their HH compliance was noted. Thereafter, questionnaire regarding knowledge, perception and attitudes toward HH was filled by each HCW.Statistical Analysis:Percentages and χ2 test.Results:The overall compliance was 43.2% (394/911 opportunities). It was 68.9% (31/45) in the intensivists, 56.3% (18/32) in attending physicians, 40.0% (28/70) in the postgraduate residents and 41.3% (301/728) in the nurses. Compliance was inversely related to activity index. Compliance for high, medium and low risk of cross-transmission was 38.8% (67/170), 43.8% (175/401) and 44.7% (152/340), respectively.Conclusions:Compliance of the study group is affected by the activity index (number of opportunities they come across per hour) and professional status. The HCWs listed less knowledge, lack of motivation, increased workload as some of the factors influencing HH.

Hand hygiene adherence according to World Health Organization Recommendations in a Neonatal Intensive Care Unit

“…Several investigators identified that the increase in workload was a negative impact factor on compliance. [20][21] Variables such as the weariness caused by work routines (severity of patient cases, NICU overcrowding, number of shifts per week, number of jobs) were not registered. Also in this study, significantly more observations were performed with nursing technicians in comparison to physicians, and physicians had the higher compliance rates.…”

Effects of “Bacterfree Hand Intervention” on the knowledge, attitude of handwashing and its technique, among pre-schoolers in Wilayah Persekutuan, Malaysia.

“…In contrast, Sharma et al proved that good knowledge might not be converted into actions. In her study, 82% doctors and 59% nurses claimed to have knowledge regarding proper hand hygiene technique 8 . However, the figure was not transformed into practices due to several reasons such as heavy workload, lazy attitude, lack of time and inadequate motivation.…”

Nurse understaffing and infection risk: current evidence, future research and health policy

“…are possible under the pressure of high workload (Hugonnet et al ., 2007a). Hand hygiene compliance of ICU nurses was found to be inversely related with the number of their activities (Sharma et al ., ), while daily proportion of infected patients was significantly correlated with nurse : patient ratio of 2, 3 and 4 days prior (Hugonnet et al ., 2007a). Job dissatisfaction, fatigue, burnout, absenteeism and increased error incidence of personnel due to high workload could also contribute to increased infection risk.…”