DETERMINING FACTORS INFLUENCING IMPLEMENTATION OF HAND HYGIENE GUIDED BY WHO GUIDELINES AT THIKA LEVEL FIVE HOSPITAL

Abstract

Background: Hand hygiene (HH) is any action of hand cleaning while maintaining good skin integrity. Proper HH prevents more than 50 % of hospital acquired infections. This study was carried out in May 2015. The aim of this study was to assess the level of implementation of WHO HH guidelines (moments of hand hygiene and hospital facilitation) among nurses working at Thika level five hospital. 
 Methodology: A descriptive cross sectional study was carried out among nurses working at Thika level five hospital in May 2015. 140 respondents were selected using systematic random sampling. Data was collected using self-administered structured questionnaire and a standard HH checklist based on WHO guidelines. Quantitative data was analyzed using SPSS version 20 and Microsoft excel. Qualitative data was coded, categorized and analyzed using SPSS version 20. 
 Results: The researcher then created a dummy variable which showed that 81 (57.9%) of the nurses were knowledgeable of hand washing recommended practices by WHO. However at 95% level of significance, nurses did not have adequate knowledge about hand washing hygiene practices as recommended by WHO guideline with a p value of 0.000. There was there was poor practice of hand hygiene practices compared to that stipulated by WHO with a p value of 0.000 at 95% level of significance. The facilitation variable showed that 40 (28.6%) of the nurses interviewed mentioned that there was adequate facilitation and access to hand hygiene but the P Value of 0.000 implies that we accept Ho. This implies that at 95% level of significance, there is inadequate facilitation of hand hygiene practices compared to that stipulated by WHO. 
 Conclusions: The results of the study suggest that the TPB provides a useful framework for conceptualizing HH among nurses. Though the healthcare institution ensured availability of most facilities/materials for effective hand hygiene practice, single us towels and alcohol hand rubs were inadequate; these two are very essential for effective outcome of hand cleaning. Several factors influenced implementation of hand hygiene guidelines e.g Availability especially for single use towels and availability of alcohol hand rub. Other factors included inadequate on job training of hand hygiene and inadequate guidelines availed to the nurses. 
 Recommendations The infection control department should avail chances for continuous hand hygiene education, facilitate practice and provide and environment that promotes the right attitude towards implementation of hand hygiene within the facility