What are the predictors of hand hygiene compliance in the intensive care unit? A cross-sectional observational study

Abstract

Background: Although appropriate hand hygiene (HH) practices are recognised as the most effective preventative strategy for infection, adherence is suboptimal. Previous studies in intensive care units (ICUs) have found differences in HH compliance between those moments that protect the patient, and those that protect the healthcare provider. However, such studies did not control for other variables known to impact HH compliance. Aim: To examine HH among healthcare workers (HCWs) in ICU settings, and identify whether there is a statistical difference in HH compliance between patient-protective and self-protective moments, while controlling for other variables known to influence HH compliance (i.e. professional role, unit and shift time). Methods: A cross-sectional observational study was conducted in four ICUs across three Irish hospitals. Compliance was assessed according to the WHO’s ‘five moments for hand hygiene’. HCW professional role, total number of ‘opportunities’ for HH and whether compliance was achieved were recorded. Results: A total of 712 HH opportunities were recorded, with an overall compliance rate of 56.9%. Logistic regression analysis revealed that physicians, allied healthcare professionals and auxiliary staff were less likely than nurses to engage in HH. HCWs were more likely to comply during night shifts compared to morning shifts, and with self-protective as compared to patient-protective HH moments. Conclusion: The information provided in this study provides a data-driven approach that ICUs can use to tailor HH interventions to where, when and for whom they are most required.

Barriers to hand hygiene compliance in intensive care units during the COVID-19 pandemic: A qualitative study

“…Healthcare workers frequently contact patients, making it easy for microorganisms to be transmitted through their hands ( 9 ). In intensive care units (ICUs), the problem is more critical due to a higher infection rate than in other wards, as well as high-risk patients due to multiple injuries, low awareness, and weak prevention mechanisms ( 10 ). Hand hygiene compliance has improved patient health and safety and decreased complications, hospital stays, and death risks.…”

“…Moreover, before contacting patients, healthcare workers exhibit a lower level of compliance than after contacting patients ( 16 ). Furthermore, another study found that hand hygiene is more commonly practiced during night shifts than morning shifts and patient protection than self-protection ( 10 ).…”

“…While this may be true, the pandemic allowed to change behavior through reactive stimuli such as fear and knowledge (increased infection rates), which led to greater compliance with hand hygiene practices ( 17 ); little information is available regarding hand hygiene compliance rates during the COVID-19 pandemic ( 17 ). Consequently, most studies have only been quantitative and have examined compliance with hand hygiene practices ( 9 , 10 ). The behavior associated with HH was also complex and challenging to comprehend, clarify, or alter ( 18 ).…”

Sanitation and Hygiene Implementation Training to Minimize The Spread of Covid 19 in Family and Consumer Science Students

“…These exercises stimulate employee attitude and behavior changes while also advancing their knowledge and abilities. [30]. For instance, enhancing moms' education while considering current viewpoints might result in favorable modifications [31].…”

Utilização de sensores infravermelhos para monitorização da higiene das mãos

“…(6) Podem fornecer estimativas das taxas de conformidade durante todos os turnos, todos os dias da semana e eventualmente categorizar conforme os diferentes profissionais. (6,47,48) Esses sistemas facilitam análise do efeito em estimar taxas de aderência de várias intervenções, como estratégias de feedback, programas como "positive deviance", efeitos da duração do observador humano e a extensão do efeito Hawthorne. (6) Apesar dos sistemas de monitoramento poderem aumentar a aderência à higiene das mãos, não podemos esquecer que os fatores humanos podem desempenhar um papel importante nesse processo.…”