Abstract
Consistent practice of hand hygiene (HH) has been shown to reduce the incidence and spread of hospital acquired infections. The objectives of this study were to determine the level of compliance and possible factors affecting compliance with HH practices among HCWs at a teaching hospital in Kingston, Jamaica. A prospective observational study was undertaken at the University Hospital of the West Indies (UHWI) over a two weeks period. Trained, validated observers identified opportunities for hand hygiene as defined by the WHO "Five Hand Hygiene Moments" and recorded whether appropriate hand hygiene actions were taken or missed. Observations were covert to prevent the observer's presence influencing the behaviour of the healthcare workers (HCWs) and targeted areas included the intensive care units (ICUs), surgical wards and surgical outpatient departments. A ward infrastructure survey was also done. Data were entered and analysed using SPSS version 16 for Windows. Chi-square analysis using Pearson's formula was used to test associations between 'exposure' factors and the outcome 'compliance'. A total of 270 hand hygiene opportunities were observed and the overall compliance rate was 38.9%. No differences were observed between the various types of HCWs or seniority. HCWs were more likely to perform hand hygiene if the indication was 'after' rather than 'before' patient contact (p = 0.001). This study underscores the need for improvement in HH practices among HCWs in a teaching hospital. Health education with particular attention to the need for HH prior to physical contact with patients is indicated.
Highlights
Consistent practice of hand hygiene (HH) has been shown to reduce the incidence and spread of hospital acquired infections
The extent to which HH practices among healthcare workers (HCWs) is a contributor to the observed pattern is not known
They present a universal challenge for all health care providing facilities since more than 1.4 million patients in both developed and developing countries are estimated to be affected at any given time [3]
Summary
Consistent practice of hand hygiene (HH) has been shown to reduce the incidence and spread of hospital acquired infections. Observations were covert to prevent the observer’s presence influencing the behaviour of the healthcare workers (HCWs) and targeted areas included the intensive care units (ICUs), surgical wards and surgical outpatient departments. Health care-associated infection (HCAI) is a major problem for patient safety [3]. HCAIs are associated with prolonged hospital stay, long-term disability, increased mortality, increased antimicrobial drug resistance and greatly increased financial burden to health care facilities and patient families [3]. They present a universal challenge for all health care providing facilities since more than 1.4 million patients in both developed and developing countries are estimated to be affected at any given time [3]. Many studies in developing countries, albeit usually single institution based, report hospital-wide rates of HCAI that are higher than in developed countries [5,6,7]
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