PO-0556 Hand Hygiene In An Indian Nicu: Scope For Improvement

Abstract

Background Stringent handwashing practice is an essential component of patient care in neonatal intensive care units. We evaluated handwashing practices followed in the Neonatal Intensive Care Unit at Shree Krishna Hospital in Karamsad, India. Methods Prospective observational study over a week in November 2013. Motion activated camera place over washbasin recorded handwashing. Six main steps i.e. step 2 to step 7 of World Health Organisation’s hand hygiene technique with soap and water were used for evaluation. Handwashing was categorised as excellent if it exceeded 20 seconds and all six steps were followed, acceptable if duration exceeded 20 seconds but only 3 steps were followed. Rest was classified as unacceptable. Results Of 1081 recordings, 775 (71.7%) were nurses, 204 (18.9%) were parents and 102 (9.4%) were of doctors. From these, 403 (37.3%) were excellent, 521 (48.2%) were acceptable and 157 (14.5%) were unacceptable handwash. From nurses, 82 (10.6%), from parents 70 (34.3%) and from doctors 5 (4.9%) were unacceptable handwash. There were 665 (61.5%) occurring during day time (8 am to 8 pm) and 416 (38.5%) during nights. Unacceptable handwashing was more prevalent in the night as compared to daytime (73 [17.5%]) vs. 84 [12.6%], p = 0.025). Twelve people washed their face after washing their hands in the night shift. Conclusion The study indicates scope for improvement with emphasis on night shifts and parents. Innovative interventions may be required for parents. Empowerment of all stakeholders with reemphasis with constructive feedback may be considered along with repeat cross sectional studies to improve quality.