Hand hygiene compliance in Dutch general practice offices

Nataliya Hilt,Marlies E J L Hulscher,Alex W Friedrich,Mariëtte Lokate,Andreas Voss,Alfons Oldeloohuis

doi:10.1186/s13690-020-00464-5

Abstract

BackgroundHand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline.MethodsAn observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional.ResultsWe monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34, 51 and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR). The median time of disinfecting hands was 8 s (range 6–11 s) for HCWs in our study.ConclusionsHH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.

Highlights

Hand hygiene (HH) is considered one of the most important measures to prevent healthcareassociated infections (HAI)
While hands certainly are a relevant route of transmission of infection, including outpatient care setting (for example, visit to a general practitioner’s (GPs) office) [2], the effectiveness of good hand hygiene has
There were no outliers in HH performance between 5 general practitioners (GPs) offices

Summary

Introduction

Hand hygiene (HH) is considered one of the most important measures to prevent healthcareassociated infections (HAI). The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline. While hands certainly are a relevant route of transmission of infection, including outpatient care setting (for example, visit to a general practitioner’s (GPs) office) [2], the effectiveness of good hand hygiene has. The World Health Organization (WHO) recommendations on hand hygiene best practices and improvement strategies within its campaign ‘Clean Care is Safer Care’ [8] are considered the gold standard for healthcare worldwide. Numerous studies over the last few decades have shown that HH compliance is generally less than 50% of all the opportunities, with regard to both: hospital and outpatient setting [11,12,13,14,15,16]. Information on hand hygiene compliance and barriers for optimal hand hygiene practices at the general practitioners level remain limited [16, 18, 19]

Objectives

Results

Conclusion