Abstract
Hand decontamination is a critical infection control practice in the prevention of nosocomial infection. This study was conducted to observe the hand hygiene practices of nurses and doctors in two intensive care units (ICUs) in Malaysia. Staff members were observed during patient contacts, and their hand washing techniques and hand hygiene practices were monitored. Five contact periods were observed for staff members while they cared for their assigned patients. Hand hygiene practices before and after patient contacts were categorized as clean uncontaminated, clean recontaminated, new gloves, and unchanged contaminated gloves. Compliance to hand-washing steps and time taken for hand washing were analyzed. Appropriate use of gloves based on CDC criteria also was assessed. Compliance to hand hygiene practices was 70% before each patient contact. Staff members did not completely adhere to the hand-washing steps. The average time taken to wash hands was 20 seconds, and the necessary steps (rubbing palm over dorsum; rubbing fingers interlaced, and rotational rubbing of thumbs) were practiced minimally by all staff. Hand washing protocol was generally followed by all staff (100%). Alcohol hand rubs were available but were used moderately (60%); when used, staff members did not wait for the alcohol to dry. Only 4% of staff changed contaminated gloves between patients. Hand hygiene compliance by ICU staff members needs to be improved. Improving adherence to correct hand hygiene techniques will require effective education programs and behavioral modification techniques. Moreover, hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied.
Highlights
Nosocomial infection (NI) is a major cause of mortality in intensive care units (ICUs) in both developed and developing countries [1]
Hand washing protocol was generally followed by all staff (100%)
Hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied
Summary
Nosocomial infection (NI) is a major cause of mortality in intensive care units (ICUs) in both developed and developing countries [1]. Adherence to hand hygiene recommendations is the most important means of preventing and controlling the spread of NIs in ICUs [2]. ICU patients are at high risk of acquiring NIs because of several risk factors that are known to contribute to the transfer of pathogenic microorganisms from patient to patient are common in these units. These risk factors include inadequate placement of wash basins and sinks, towels, and hospital supplies; invasive procedures; inappropriate use of antibiotics; lack of knowledge about infection control practices; overcrowding; and high patient to nurse ratios [4]. This study was conducted to observe the hand hygiene practices of nurses and doctors in two intensive care units (ICUs) in Malaysia
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