Variability in hand hygiene practices among internal medicine interns

Block, Lauren; Habicht, Robert; Oluyadi, Fareedat; Wu, Albert W.; Desai, Sanjay V.; Niessen, Timothy; Silva, Kathryn Novello; Oliver, Nora; Feldman, Leonard

doi:10.1016/j.ajic.2013.03.303

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…Both quantitative (survey, observation) and qualitative (interviews) studies responded to the questions asked by the authors of this paper regarding poor compliance with HH rules by physicians. Although the long history of HAI surveillance in the world indicates HH as a primary activity in HAI prevention, many scientific reports indicate deficiencies in knowledge in this area [ 2 , 6 , 7 , 18 , 24 ]. Also, on the basis of studies conducted in Poland, it can be concluded that compliance with HH rules by medical personnel is far from what should be expected [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…HH is not always conducted in accordance with the principle of the 5 Moments for HH, and compliance with these rules is estimated at around 40% of needs [ 5 ]. Particularly low compliance rates were obtained in studies conducted among interns [ 6 , 7 ]. The results of studies conducted by different Polish authors also show low compliance rates with HH recommendations [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture?

Wałaszek

Kołpa

Wolak

et al. 2017

IJERPH

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Objective: The objective of the study was to examine the knowledge of Polish physicians and medical students about the role of hand hygiene (HH) in healthcare-associated infection (HAI) prevention. Study design: A survey was conducted using an author-prepared questionnaire, which was filled out on the first day of hospital work (or internship) by newly admitted physicians who had worked in other hospitals and students of different medical schools in Poland. Methods: 100 respondents participated in the study: 28 students, 18 medical interns and 54 physicians. Results: As many as 3/4 of physicians and students did not use the HH techniques correctly. The respondents declared that they perform HH in the following situations: 74.4% of respondents before an aseptic task; 60.8% before patient contact; 57.0% after patient contact; 11.5% after body fluid exposure risk, and only two respondents (1.1%) after contact with patient surroundings. 64% of respondents declared that their supervisor checked their knowledge of the HH technique when they were touching patients, but their supervisors checked the five instances for HH only in the case of 27 respondents (27%). Students experienced any control of HH in the workplace less often. Interns and physicians mentioned that the most important preventive action in HAI is HH, but for students it is the use of gloves. Conclusions: The level of knowledge and skills of physicians and students in the field of HH is insufficient. Deficiencies in skills and knowledge of HH were identified as early as at the level of the first internship.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture?

Wałaszek

Kołpa

Wolak

et al. 2017

IJERPH

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“…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) , confirming the low consistency rates.Intensive care units are among the most investigated sites for checking hand hygiene compliance rates. However, the development of studies in other healthcare settings that are as complex and dynamic as ICUs is very important.…”

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confidence: 85%

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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“…Violations of established policy are widespread within our medical system and have proven, as with hand hygiene, to be difficult to eradicate [84]. Institution of checklists, process changes, and audits (bundled approach) have proven to be effective in reducing violations surrounding central lines as well as subsequent infection rates [10,85].…”

Section: Personal Readiness Violationsmentioning

confidence: 99%

Improving Patient Safety in the Cardiac Operating Room: Doing the Right Thing the Right Way, Every Time

Wahr

Abernathy

2014

Curr Anesthesiol Rep

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The past 5 decades have seen an incredible advance in cardiac surgery knowledge, techniques, equipment, skill sets, and outcomes. Even as our average cardiac surgery patient becomes older with more significant cardiac disease and medical comorbidities, mortality continues to decrease. However, many of the deaths that do occur have been shown to be preventable. These preventable deaths are more often due to non-technical errors, such as communication failures, distractions, and disruptions, than to a failure of technical skill or knowledge. Further improvements in patient outcome require optimizing team performance, in both what the team does (evidence-based best practices) and how they do it (optimizing team performance, reduction of error, improved tools and technologies). Interventions such as formal team training, checklists, briefings and debriefings, cognitive aids, and handover tools have been shown to decrease disruptions and reduce patient mortality. Optimizing team performance will require adoption of a just culture, where errors are not met with ''blame and shame'' but as due to system hazards to be resolved, but where personal accountability is also present. The journey to habitual excellence should not be viewed as a draconian elimination of human error, but one of continuous optimization of team performance.

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Variability in hand hygiene practices among internal medicine interns

Cited by 4 publications

References 9 publications

Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture?

Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture?

Hand hygiene compliance of healthcare professionals in an emergency department

Improving Patient Safety in the Cardiac Operating Room: Doing the Right Thing the Right Way, Every Time

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