Hospital hand hygiene opportunities: Where and when (HOW2)? The HOW2 Benchmark Study

Steed, Connie; Kelly, J. William; Blackhurst, Dawn W.; Boeker, Sue; Diller, Thomas; Alper, Paul; Larson, Elaine

doi:10.1016/j.ajic.2010.10.007

Cited by 70 publications

(56 citation statements)

References 11 publications

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“…Indications after contact with the patient were observed in 27% of the sessions, followed by indications after contact with areas that are close to the patient, observed in 24.9% of the sessions. These results are in line with studies in ICUs (14)(15)(16) that have carried out most observations of indications after contact with the patient, followed by contact with areas that are close to the patient, and then followed by contact with the patient and near areas. This evidence indicates that healthcare professionals in both emergency rooms and ICUs may be concerned about the risk of disease acquisition after the performance of procedures, and exposure to bodily fluids and potentially contaminated areas.…”

Section: Hand Hygiene Practice Characterizationsupporting

confidence: 80%

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Hand hygiene compliance of healthcare professionals in an emergency department

Zottele

Magnago

Dullius

et al. 2017

Rev. esc. enferm. USP

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Objective:To analyze compliance with hand hygiene by healthcare professionals in an emergency department unit. Method: This is a longitudinal quantitative study developed in 2015 with healthcare professionals from a university hospital in the state of Rio Grande do Sul. Each professional was monitored three times by direct non-participant observation at WHO's five recommended moments in hand hygiene, taking the concepts of opportunity, indication and action into account. Descriptive and analytical statistics were used. Results: Fifty-nine healthcare professionals participated in the study. The compliance rate was 54.2%. Nurses and physiotherapists showed a compliance rate of 66.6% and resident physicians, 41.3%. When compliance was compared among professional categories, nurses showed greater compliance than resident physicians (OR=2.83, CI=95%:1.09-7.34). Conclusion: Hand hygiene compliance was low. Multidisciplinary approaches could be important strategies for forming partnerships to develop learning and implementation of hand hygiene practices. Hand hygiene compliance of healthcare professionals in an emergency department* Adesão dos profissionais de saúde à higienização das mãos em pronto-socorro Adhesión de los profesionales sanitarios a la higienización de las manos en servicio de urgencias DESCRIPTORS INTRODUCTIONHealthcare-related infections (HCRI) are adverse events that occur in healthcare services worldwide, even when broadly avoidable (1) . A study of the prevalence of HCRI, coordinated by the World Health Organization (WHO) in 55 hospitals in 14 countries in Asia, Europe, the Eastern Mediterranean and the Western Pacific revealed that on average 8.7% of patients experience infections during hospitalization (2) . In developed countries, HCRI rates ranged from 5% to 15% in hospitalized patients, and may have affected from 9% to 37% of patients admitted to intensive care units (ICUs) (2) . In 2004, the World Alliance for Patient Safety launched their First Global Challenge, with a central focus on HCRI prevention. In Brazil, the challenge was entitled "Clean Care is Safer Care." It was implemented in the biennium [2005][2006], aiming at promoting hand hygiene as a sensitive and effective method to prevent infections (2) . Even 10 years later, the proposal focused on patient safety, which points to hand hygiene as a simple and effective measure in the prevention of HCRI still has an impact on current clinical and care practices in different services (3) . Although scientific evidence points to a relationship between an increase in hand hygiene and reduction of HCRI rates, consistency and compliance rates remain low (4)(5) . There are efforts to increase this practice; however, the general rate of hand hygiene compliance has been around 40%, varying from 5% to 81% (6) . Scientific evidence has shown a compliance rate of 20% by ICU healthcare professionals (nurses, physicians and physiotherapists) (7)(8) , 29% in emergency rooms (9) , and 40% among medical students in open units (10) , confirmin...

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Section: Hand Hygiene Practice Characterizationsupporting

confidence: 80%

“…There were 166 opportunities for hand hygiene during 111 days of monitoring, with an average duration of 11 min (SD=50 seconds) per session. A Colombian study evaluated 180 opportunities with 26 health professionals (14) . In a reference hospital survey in Mali in Africa, the monitoring sessions had a mean duration of 16 min (ranging from 1 to 51 min) (5) .…”

mentioning

confidence: 99%

Hand hygiene compliance of healthcare professionals in an emergency department

Zottele

Magnago

Dullius

et al. 2017

Rev. esc. enferm. USP

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“…In most healthcare settings monitoring of compliance with hand hygiene is based on the WHO hand hygiene observation method, although the recommendations to train and validate observers to ensure consistency is probably not commonly performed (Sax et al, 2009). There is little data on the IRR of this method (Steed et al, 2011;Huis et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

The misuse and overuse of non-sterile gloves: application of an audit tool to define the problem

Wilson

Prieto

Singleton³

et al. 2015

Journal of Infection Prevention

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Background: The use of non-sterile gloves (NSG) has become routine in the delivery of health care, often for procedures for which they are not required; their use may increase the risk of cross contamination and is generally not integrated into hand hygiene audit. This paper describes a small-scale application and validation of an observational audit tool devised to identify inappropriate use of NSG and potential for cross contamination. Methods: Two observers simultaneously observed the use of NSG during episodes of care in an acute hospital setting. The inter-rater reliability (IRR) of the audit tool was measured corrected for chance agreement using Kappa. Results: A total of 22 episodes of care using NSG were observed. In 68.6% (24/35) of procedures there was no contact with blood/body fluid; in 54.3% (19/35) NSG-use was inappropriate. The IRR was 100% for eight of 12 components of the tool. For hand hygiene before and after NSG removal it was 82% (Kappa = 0.72) and 95% (Kappa = 0.87). Conclusions: In this small-scale application of a glove-use audit tool we demonstrated over-use and misuse of NSG and potential for cross transmission on gloved hands. The audit tool provides an effective mechanism for integrating glove use into the audit of hand hygiene behaviour.

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“…Since 2009, our institution has been involved in developing and deploying such a system (DebMed GMS; DebMed USA, Charlotte, NC) to deliver real-time World Health Organization's My 5 Moments for Hand Hygiene (WHO5) 1 HHC data to individual hospital nursing units. 2,3 The purpose of our current study was to determine if implementation and use of this system by the unit leadership was effective in reducing the unit-specific incidence of health care-associated methicillin-resistant Staphylococcus aureus (MRSA) infection.…”

mentioning

confidence: 99%