Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Pfäfflin, Frieder; Tufa, Tafese Beyene; Getachew, Million; Nigussie, Tsehaynesh; Schönfeld, Andreas; Häussinger, Dieter; Feldt, Torsten; Schmidt, Nicole

doi:10.1186/s13756-016-0165-9

Cited by 60 publications

(69 citation statements)

References 26 publications

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“…Among the disinfectants (e.g. aldehyde, halogen-releasing agents, phenols), alcohols are the most used due to their good effectiveness, low cost and availability, especially in less developed countries (5,6). Although several alcohols have been considered to have antimicrobial effects, only three of them are widely used, namely ethyl alcohol -ethanol, isopropyl alcohol -isopropanol (or propan-2-ol), and n-propyl alcohol -n-propanol (or propan-1-ol) (7).…”

Section: Introductionmentioning

confidence: 99%

Effects of low-molecular weight alcohols on bacterial viability

Man

Gâz

Mare

et al. 2017

Revista Romana De Medicina De Laborator

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Section: Introductionmentioning

confidence: 99%

Effects of low-molecular weight alcohols on bacterial viability

Man

Gâz

Mare

et al. 2017

Revista Romana De Medicina De Laborator

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“…PASQUALE baseline and follow-up assessments found better overall results than studies conducted in university hospitals in comparable settings such as Mali and Ethiopia [11,12]. space and belongings are often shared [11].…”

Section: Discussionmentioning

confidence: 76%

Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

Müller

Diallo

Wood

et al. 2020

Preprint

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Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

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“…Low hand hygiene practices is common in other countries in Africa and Asia as reported in other countries, the main reason being lack of knowledge on how proper hand hygiene is practiced, sensitisation and lack of ABHR for hand decontamination. 15,[23][24][25] High workload and facility ownership are additional factors linked with low compliances of hand hygiene as reported by studies in India and China, where low compliance of hand hygiene was noted more frequently in public compared to private facilities. [26][27][28] Although an improvement in hand hygiene compliance was observed in the current study, little improvement was observed in washing hands with water or ABHR for at least 2 minutes and wearing sterile gloves correctly before procedure.…”

Section: Discussionmentioning

confidence: 95%

Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study

Sengoka¹,

Rasmussen²,

Msuya³

et al. 2019

EAHRJ

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Background: Health-care-associated infection (HCAI) is a big challenge in both low-and high-income countries. Around childbirth, infection is among the main causes of maternal and perinatal morbidity and mortality. Appropriate hand hygiene practice is a simple and cost-effective way of reducing HCAIs. This study aimed to assess the baseline performance and knowledge of proper hand hygiene during caesarean sections and the impact of interventions guided by a criterion-based audit at a tertiary health facility in Tanzania. Methods: A noncontrolled, before-and-after intervention study, guided by a criterion-based audit, was carried out. A criterion based checklist was used for direct observations of hand hygiene performance during cesarean section. A self-administered questionnaire was used to assess knowledge on infection prevention. Performance was compared before and after a half-way intervention. Results: At baseline, low-quality hand hygiene performance was observed. Significant improvements of hand hygiene performance were observed for a number of criteria. Long nails: performance reduction from 15 (25%) to 3 (5%) (P=.04), polished nails: from 11 (18%) to 1 (2%) (P=.04), a score increase in hand wash with water from 43.8 (73%) to 60 (100%) (P=.001). Postoperatively, correct glove removal increased from 20 (33%) to 37.8 (66%) (P=.01). Alcohol-based hand rub use increased from 2 (3%) to 21 (35%) (P=.001). The number of health-care workers who did not wash hands after procedure with either water or alcohol-based hand rub reduced from 35 (58%) to 10 (17%) (P=.001). After the intervention, poor knowledge among health-care workers reduced from 7 (39%) to 3 (17%), while moderate knowledge increased from 8 (44%) to 12 (67%). Conclusion: Feedback, discussion of findings, training, visual reminders, and distribution of alcohol-based hand rub, as part of a criterion-based audit is a powerful way of improving hand hygiene performance and knowledge in surgical wards.

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Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Cited by 60 publications

References 26 publications

Effects of low-molecular weight alcohols on bacterial viability

Effects of low-molecular weight alcohols on bacterial viability

Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study

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