Improving children's and their visitors' hand hygiene compliance.

Dina Lary,Jacqueline Randle,Natalie Vaughan,Joel Segal,Kim R Hardie,Aaron Calvert,Brigitte Nerlich

doi:10.1177/1757177419892065

Abstract

Numerous interventions have tried to improve healthcare workers' hand hygiene compliance. However, little attention has been paid to children's and their visitors' compliance. To test whether interactive educational interventions increase children's and visitors' compliance with hand hygiene. This was a cluster randomised study of hand hygiene compliance before and after the introduction of educational interventions. Observations were compared for different moments of hygiene and times of the day. Qualitative data in the form of questionnaire-based structured interviews were obtained. Hand hygiene compliance increased by 24.4% (P < 0.001) following the educational interventions, with children's compliance reaching 40.8% and visitors' being 50.8%. Compliance varied depending on which of the five moments of hygiene was observed (P < 0.001), with the highest compliance being 'after body fluid exposure' (72.7%). Responses from questionnaires showed educational interventions raised awareness of the importance of hand hygiene (69%, 57%) compared to those who had not experienced the educational intervention (50%). Educational interventions may result in a significant increase in children's and visitors' hand hygiene (P < 0.001).

Highlights

Numerous interventions have tried to improve healthcare workers' hand hygiene compliance, little attention has been paid to children's and their visitors’ compliance
Educational interventions may result in a significant increase in children's and visitors' hand hygiene (P
Hand hygiene compliance increased by 21.4% (P

Summary

Introduction

Numerous interventions have tried to improve healthcare workers' hand hygiene compliance, little attention has been paid to children's and their visitors’ compliance. (NICE, 2017) calls for education providers and parents to do more to promote good hand hygiene practices. This is especially relevant when considering children's vulnerability in healthcare settings where are children treated by a plethora of healthcare workers who travel in and out of different clinical settings, but they are typically surrounded by ill people. To prevent and reduce HCAI transmission, it is important to determine if the main routes of exposure to infection are direct, indirect, or due to repeated person-to-person contact. The transmission of infections is likely to correlate with their natural behaviour (e.g. regular exploration of their mouths). The resultant spread of respiratory secretions coupled with an immature immune system combine to increase children's risk of infections (Snow et al, 2008) and they are especially at high risk of respiratory infections and gastrointestinal diseases (Stein et al, 2007)

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