Evaluation of hand hygiene practices of health care workers in tertiary care hospital by systematic hand hygiene audits

Abstract

: Hand hygiene (HH) holds a pivotal role in infection control. However, compliance with hand hygiene has remained low worldwide. Hospital Acquired Infection (HAI) incidence is rising in most healthcare facilities. It is postulated that around 30% of HAI can be reduced by following strict hand hygiene protocols by healthcare workers (HCWs). This study was done to evaluate the level of compliance of healthcare personnel in our tertiary care hospital with respect to appropriate hand hygiene practices by employing HH audits. A cross-sectional observational study was conducted in a tertiary care teaching hospital over six months. A single‑ observer direct observation technique was used to collect the HH compliance data conducted by trained Infection control nurses. HCWs, including doctors, nurses, CRMIs and technicians, were observed for compliance in all the critical areas, outpatient and inpatient sections across all departments. The HH audit form designed based on the WHO's HH audit tool kit was used in the study. The audits were conducted randomly in all the areas for at least 20 minutes per day. : A total of 583 HCWs were observed for the Hand Hygiene Compliance audit. The overall HH compliance rate was 67.88%, with doctors at 74.31%, followed by nurses at 70.42%. Compliance was observed in OBG/Labour ward at 78.7% and the oncology ward at 78.5%. WHO moments-specific hand hygiene adherence showed the least compliance rate of 55% for moment 1, followed by moment 5 with 58.9%. Best compliance was observed for moment 3, with 79.2%.: The overall hand hygiene compliance was comparatively better in our study. Specific measures such as improved facilities, training and monitoring are needed to attain good H`H compliance.