The World Health Organization ‘5 Moments of Hand Hygiene’

Chou, David; Achan, Pramod; Ramachandran, Manoj

doi:10.1302/0301-620x.94b4.27772

Cited by 51 publications

(45 citation statements)

References 62 publications

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“…13-15 Clinical practice as seen in our study suggests that strict adherence to the WHO ‘My 5 Moments’ of HH may be infeasible in the setting of active resuscitation. Creating a set of guidelines that focuses on glove use for HH before and after patient care, after contact with body fluids and before certain clean procedures may be more effective in promoting HH compliance.…”

Section: Discussionmentioning

confidence: 84%

Hand Hygiene Compliance in the Setting of Trauma Resuscitation

Haac

Rock

Harris

et al. 2017

Injury

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Background Healthcare-associated infections are a significant health burden, and hand hygiene (HH) is an essential prevention strategy. World Health Organization (WHO) 2009 guidelines recommend washing hands during five moments of patient care; 1) before touching a patient; 2) before a clean procedure; 3) after body fluid exposure; and 4) after touching a patient or 5) patient surroundings. HH opportunities at these 5 moments are frequent and compliance is low (22-60%). Infection risk is particularly high in trauma patients, and HH compliance during active trauma resuscitation has yet to be evaluated. Study Design Using video surveillance, all healthcare worker (HCW)-patient interactions for 30 patients were retrospectively reviewed for HH compliance according to WHO guidelines and glove use during initial resuscitation at a level-1 trauma center. Results 342 HCW-patient interactions and 1034 HH opportunities were observed. HH compliance with the WHO moments was 7% (71/1034) overall; 3% (10/375) before patient contact, 0% (0/178) before a clean procedure, 11% (2/19) after body fluid contact, 15% (57/376) after patient contact and 2% (2/86) after contact with the environment. Glove use was more common, particularly before (69%) and after (47%) patient contact and after body fluid contact (58%). No HH was observed before clean procedures, but HCW donned new gloves 75% of the time before bedside procedures. If donning/removing gloves was included with HH as compliant, compliance was 57% overall. Conclusion HH opportunities are frequent and compliance with WHO HH guidelines may be infeasible, requiring significant amounts of time that may be better spent with the patient during the golden hour of trauma resuscitation. In an era where more scrutiny is being applied to patient safety, particularly the prevention of inpatient infections, more research is needed to identify alternative strategies (e.g. glove use, prioritizing moments) that may more effectively promote compliance in this setting.

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Section: Discussionmentioning

confidence: 84%

Hand Hygiene Compliance in the Setting of Trauma Resuscitation

Haac

Rock

Harris

et al. 2017

Injury

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“…We know that the most common transmission of MRSA is from the healthcare workers' hands and clothes (Bolon ; Chou et al. ). Awareness of this fact also worried many of the participants, for example that they could carry the infection to other patients.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the most common route of bacterial transmission in the healthcare environment is via indirect contact with the contaminated hands of staff, but MRSA can also be spread via clothes, equipment and various other items (Chou et al. ; Morgan et al. ).…”

Section: Introductionmentioning

confidence: 99%

Experiences of nursing staff caring for patients with methicillin‐resistant Staphylococcus aureus

Andersson

Gleissman

Lindholm

et al. 2016

International Nursing Review

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“…This is also true historically across the health spectrum, ranging from the use of vitamin C to prevent scurvy (250 years before routine implementation) [28], to hand washing (100 years before routine implementation) [29], to a host of interventions and diagnostics that over treat, undertreat or mistreat patients (more than 15 years for routine implementation) [30]. …”

Section: Discussionmentioning

confidence: 99%

Dental sealant knowledge, opinion, values and practice of Spanish dentists

et al. 2013

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BackgroundMultiple guidelines and systematic reviews recommend sealant use to reduce caries risk. Yet, multiple reports also indicate that sealants are significantly underutilized. This study examined the knowledge, opinions, values, and practice (KOVP) of dentists concerning sealant use in the southwest region of Andalusia, Spain. This is a prelude to the generation of a regional plan for improving children’s oral health in Andalusia.MethodsThe survey’s target population was dentists working in western Andalusia, equally distributed in the provinces of Seville, Cadiz, and Huelva (N=2,047). A convenience sample of meeting participants and meeting participant email lists (N=400) were solicited from the annual course on Community and Pediatric Dentistry. This course is required for all public health sector dentists, and is open to all private sector dentists. Information on the dentist’s KOVP of sealants was collected using four-part questionnaire with 31, 5-point Likert-scaled questions.ResultsThe survey population demographics included 190 men (48%) and 206 women (52%) with an average clinical experience of 10.6 (± 8.4) years and 9.3 (± 7.5) years, respectively. A significant sex difference was observed in the distribution of place of work (urban/suburb) (p=0.001), but no sex differences between working sector (public/private). The mean ± SD values for each of the four KOVP sections for pit and fissure sealants were: knowledge = 3.57 ± 0.47; opinion = 2.48 ± 0.47; value = 2.74 ± 0.52; and practice = 3.48 ± 0.50. No sex differences were found in KOVP (all p >0.4). Independent of sex: knowledge statistically differed by years of experience and place of work; opinion statistically differed by years of experience and sector; and practice statistically differed by years of experience and sector. Less experienced dentists tended to have slightly higher scores (~0.25 on a Likert 1–5 scale). Statistically significant correlations were found between knowledge and practice (r=0.44, p=0.00) and between opinion and value (r=0.35, p=0.00).ConclusionsThe results suggest that, similar to other countries, Andalusian dentists know that sealants are effective, have neutral to positive attitudes toward sealants; though, based on epidemiological studies, underuse sealants. Therefore, methods other than classical behavior change (eg: financial or legal mechanisms) will be required to change practice patterns aimed at improving children's oral health.

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The World Health Organization ‘5 Moments of Hand Hygiene’

Cited by 51 publications

References 62 publications

Hand Hygiene Compliance in the Setting of Trauma Resuscitation

Hand Hygiene Compliance in the Setting of Trauma Resuscitation

Experiences of nursing staff caring for patients with methicillin‐resistant Staphylococcus aureus

Dental sealant knowledge, opinion, values and practice of Spanish dentists

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