Improving hand hygiene measures in low-resourced intensive care units: experience at the Kigali University Teaching Hospital in Rwanda

Abstract

Background: Proper hand hygiene (HH) practices have been shown to reduce healthcare-acquired infections. Several potential challenges in low-income countries might limit the feasibility of effective HH, including preexisting knowledge gaps and staffing. Aim: We sought to evaluate the feasibility of the implementation of effective HH practice at a teaching hospital in Rwanda. Methods: We conducted a prospective quality improvement project in the intensive care unit (ICU) at the Kigali University Teaching Hospital. We collected data before and after an intervention focused on HH adherence as defined by the World Health Organization ‘5 Moments for Hand Hygiene’ and assuring availability of HH supplies. Pre-intervention data were collected throughout July 2019, and HH measures were implemented in August 2019. Post-implementation data were collected following a 3-month wash-in. Results: In total, 902 HH observations were performed to assess pre-intervention adherence and 903 observations post-intervention adherence. Overall, HH adherence increased from 25% (222 of 902 moments) before intervention to 75% (677 of 903 moments) after intervention (P < 0.001). Improvement was seen among all health professionals (nurses: 19–74%, residents: 23–74%, consultants: 29–76%). Conclusions: Effective HH measures are feasible in an ICU in a low-income country. Ensuring availability of supplies and training appears key to effective HH practices.

Building capacity for point of care alcohol-based handrub (ABHR) and hand hygiene compliance among health care workers in the rural maternity and surgical units of a hospital in Cameroon

“…Furthermore, we observed a significant increase in ABHR usage in the participating units. Other studies conducted in LMIC, including Rwanda, 19 Malawi, 20 and Vietnam 21 also found a significant improvement in HH compliance following the implementation of HH improvement interventions which involved ensuring continuous availability of ABHR and handwashing facilities. However, these interventions were multimodal, thus, the effect of individual intervention components remains uncertain.…”

Predictors of Compliance to Hand Hygiene among Health Care Workers in Rwanda

“…Few studies conducted about hygiene compliance in health care settings among healthcare providers in Rwanda, either focused on one hospital or even one department. [7,8,9,10,11,12] The current study aimed at determining the prevalence of hand hygiene compliance among health care workers and related predictors from selected departments in 26 hospitals of Rwanda.…”