Healthcare Hygiene Research Articles

Infection prevention: laying an essential foundation for quality universal health coverage

Infection prevention: laying an essential foundation for quality universal health coverage

Good hand hygiene practice: improvements and strategies

Even in 2019, handwashing practice among health professionals remains poor. George Winter explores the history of good hygiene in healthcare and suggests reasons why some professionals may not be reaching ‘optimal’ handwashing practice

Effectiveness of Hand Hygiene Training by Kirkpatrick Model

The aim of this organisational development was to improve Hand Hygiene education and training compliance in Hospital by extension, improve hand hygiene compliance. Hand Hygiene is identified as the single most important intervention in reducing the transmission of Healthcare Associated Infections (HAIs). In 2009, The World Health Organization published comprehensive evidence-based guidelines on Hand Hygiene in healthcare, which introduced a standardized approach to Hand Hygiene practice; “The Five Moments for hand Hygiene”. These guidelines have been adopted by the hospital and core to our education and training programme. The model was used to guide this research. The Kirkpatrick model was employed to evaluate the hand hygiene education and training, effectiveness of training at the different levels was being evaluated through construct on the basis of literature review. For level the respondents are who had completed training 7 months earlier. The results indicated that reaction of the participants were positive for training, secondly they had applied skills and knowledge which they had learnt from training. However, advanced research is needed to asses the impact of applying hand hygiene on spread of infection in hospital patient through measuring HAIs rate in this hospital.

Knowledge of final-year medical students at the University of the Free State of hand hygiene as a basic infection control measure

Background: One of the main reasons for the spread of infection in the healthcare environment is inadequate hand hygiene. Poor knowledge of hand hygiene techniques leads to poor compliance. This study aimed to determine Free State University finalyear medical students’ knowledge of hand hygiene as a basic infection control measure. Methods: This was a cross-sectional study using self-administered anonymous questionnaires. The questions and memorandum were based on an extensive literature review with WHO documentation on the guidelines for hand hygiene in health care. Each participant received an envelope with an optical computer card, questionnaire and information document during a pre-arranged class. Participants recorded their answers on the card by shading in the squares corresponding to their responses.Results: The average score of the 107 participants was 46.8% (range 10.1–73.6%). Participants who felt that they had basic knowledge of hand hygiene (n = 32, 30.5%) had an average score of 47.9%. Participants with a self-reported knowledge level of more than basic but less than advanced (n = 56, 53.3%) had an average score of 44.9% while those who reported advanced knowledge (n = 17, 16.2%) had an average score of 50.8%. Three-quarters (n = 81, 77.1%) felt that their training was sufficient. Only 53.3% knew that the most important way to prevent the spread of infection is good hand hygiene. Only 10.5% of the students knew that hands should not be rinsed with water after using alcohol-based sanitisers.Conclusion: Medical students have a poor level of knowledge regarding hand hygiene as a basic measure of infection control.

Motivating Process Compliance through Individual Electronic Monitoring: An Empirical Examination of Hand Hygiene in Healthcare

The design and use of standard processes are foundational recommendations in many operations practices. Yet, given the demonstrated performance benefits of standardized processes, it is surprising that they are often not followed consistently. One way to ensure greater compliance is by electronically monitoring the activities of individuals, although such aggressive monitoring poses the risk of inducing backlash. In the setting of hand hygiene in healthcare – a context where compliance with standard processes is frequently less than 50% and where this lack of compliance can result in negative consequences – we investigated the effectiveness of electronic monitoring. We did so using a unique, RFID-based system deployed in 71 hospital units. We found that electronically monitoring individual compliance resulted in a large, positive increase in compliance. We also found that there was substantial variability in the effect across units and that units with higher levels of pre-activation compliance experienced increased benefits from monitoring relative to units with lower levels of pre-activation compliance. By observing compliance rates over three-and-a-half years, we investigated the persistent effects of individual monitoring and found that compliance rates initially increased before they gradually declined. Additionally, in multiple units, individual monitoring was discontinued, allowing for an investigation of the impact of removing the intervention on compliance. Surprisingly, we found that after removal, compliance rates declined to below pre-activation levels. Our findings suggest that although individual electronic monitoring can dramatically improve process compliance, it requires sustained managerial commitment.

Hand hygiene 2017—it's up to you

British Journal of Healthcare AssistantsVol. 11, No. 5 Health MattersHand hygiene 2017—it's up to youPeter BradleyPeter BradleySearch for more papers by this authorPeter BradleyPublished Online:11 May 2017https://doi.org/10.12968/bjha.2017.11.5.258AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References World Health Organisation (WHO) (2009) WHO guidelines on hand hygiene in health care. www.who.int/gpsc/5may/tools/9789241597906/en/ (accessed 24 April 2017) Google Scholar FiguresReferencesRelatedDetails 2 May 2017Volume 11Issue 5ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 11 May 2017 Published in print 2 May 2017 Information© MA Healthcare LimitedPDF download

Motivating Process Compliance Through Individual Electronic Monitoring: An Empirical Examination of Hand Hygiene in Healthcare

The design and use of standard processes are foundational recommendations in many operations practices. Yet, given the demonstrated performance benefits of standardized processes, it is surprising that they are often not followed consistently. One way to ensure greater compliance is by electronically monitoring the activities of individuals, although such aggressive monitoring poses the risk of inducing backlash. In the setting of hand hygiene in healthcare, a context where compliance with standard processes is frequently less than 50% and where this lack of compliance can result in negative consequences, we investigated the effectiveness of electronic monitoring. We did so using a unique, radio frequency identification (RFID)-based system deployed in 71 hospital units. We found that electronically monitoring individual compliance resulted in a large, positive increase in compliance. We also found that there was substantial variability in the effect across units and that units with higher levels of preactivation compliance experienced increased benefits from monitoring relative to units with lower levels of prepreactivation compliance. By observing compliance rates over three and a half years, we investigated the persistent effects of individual monitoring and found that compliance rates initially increased before they gradually declined. Additionally, in multiple units, individual monitoring was discontinued, allowing for an investigation of the impact of removing the intervention on compliance. Surprisingly, we found that, after removal, compliance rates declined to below prepreactivation levels. Our findings suggest that, although individual electronic monitoring can dramatically improve process compliance, it requires sustained managerial commitment. This paper was accepted by Serguei Netessine, operations management.

Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

AimTo describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital.SettingA rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India.MethodThe study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used.ResultsOut of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to ‘always’ practice hand hygiene in the selected situations varied from 40–96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future.ConclusionSelf-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers’ knowledge and understanding regarding the importance of persistent practice in all situations.

Zika virus and the Olympics

British Journal of MidwiferyVol. 24, No. 7 CommentZika virus and the OlympicsGeorge F WinterGeorge F WinterSearch for more papers by this authorGeorge F WinterPublished Online:11 Jul 2016https://doi.org/10.12968/bjom.2016.24.7.464AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alshammari SM, Mikler AR (2016) Modeling Disease Spread at Global Mass Gatherings: Data Requirements and Challenges. In: Boonkrong SUnger HMeesad P, eds. Recent Advances in Information and Communication Technology. Part II. Springer International Publishing, Cham, Switzerland: 17–26 Crossref, Google ScholarAl Turki YA (2016) Mass Gathering Medicine New discipline to Deal with Epidemic and Infectious Diseases in the Hajj Among Muslim Pilgrimage: A Mini Review Article. J Relig Health 55(4): 1270–4 Crossref, Google ScholarAttaran A (2016) Off the Podium: Why public health concerns for global spread of Zika virus means that Rio de Janeiro's 2016 Olympic Games must not proceed. http://tinyurl.com/hsmlav2 (accessed 27 June 2016) Google ScholarBarasheed O, Rashid H, Alfelali M et al. (2014) Viral respiratory infections among Hajj pilgrims in 2013. Virol Sin 29(6): 364–71 Crossref, Google ScholarLadhani SN, O'Connor C, Kirkbride H, Brooks T, Morgan D (2016) Outbreak of Zika virus disease in the Americas and the association with microcephaly, congenital malformations and Guillain-Barré syndrome. Arch Dis Child 101(7): 600–2 Crossref, Google ScholarSinger P (1979) Practical Ethics. Cambridge University Press, Cambridge Google ScholarSoliman T, Cook AR, Coker RJ (2015) Pilgrims and MERS-CoV: what's the risk? Emerg Themes Epidemiol 12: 3. doi: https://doi.org/10.1186/s12982-015-0025-8 Crossref, Google ScholarWorld Health Organization (2009) WHO guidelines on hand hygiene in health care: first global patient safety challenge. Clean care is safer care. WHO, Geneva Google ScholarWorld Health Organiaation (2016) WHO statement on the third meeting of the International Health Regulations (2005) (IHR(2005)) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations. http://tinyurl.com/jp9b3jt (accessed 27 June 2016) Google Scholar FiguresReferencesRelatedDetails 2 July 2016Volume 24Issue 7ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 11 July 2016 Published in print 2 July 2016 Information© MA Healthcare LimitedPDF download

Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa.

OBJECTIVE To improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization's (WHO's) Guidelines on Hand Hygiene in Health Care. DESIGN This study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration's support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation. SETTING A 160-bed, non-referral hospital in Gitwe, Rwanda PARTICIPANTS A total of 12 physicians and 54 nurses participated in this study. METHODS The intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey. RESULTS Overall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P.05). CONCLUSION Hand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA. Infect Control Hosp Epidemiol 2016;37:834-839.

Motivating Process Compliance Through Individual Electronic Monitoring: An Empirical Examination of Hand Hygiene in Healthcare

Motivating Process Compliance Through Individual Electronic Monitoring: An Empirical Examination of Hand Hygiene in Healthcare

The current situation in compliance with hand hygiene in dental surgeries in the Czech Republic

Implementation and compliance with hand hygiene in health care is different and depends on the type of separation. Hand Care is very important for the prevention of transmission of infectious agents between patients and dentist’s protection against infection. Their microbial contamination occurs when bioaerosol contacts hands and during a treatment of the patient. The literature indicates that the degree of “compliance” in compliance with hand hygiene in a dental surgery is between 16-81%, with an average of 40%.

Using modern concepts to engage the world in an annual public health campaign

Background Public health campaigning has been used for a number of decades to promote awareness and understanding about health issues and to mobilize action. In 2015, billions of people across the world have the opportunity to access and support campaigns due to the ownership of smart, mobile technologies. The WHO SAVE LIVES: Clean Your Hands campaign is in its 7th year. In order to maximize the impact of this global annual campaign, each year a new creative focus is given to the topic of hand hygiene in health care.

Hand hygiene improvement in Nigeria: challenges and opportunities

Preventable infections contribute significantly to disease burden in Nigeria. Improving hand hygiene in healthcare, communities and general population can break the chain in the spread of most germs that threaten health and drag on socioeconomic development. Hand hygiene is fundamental to patient safety and important to occupational health – both are interconnected. The occupational health benefits of hand hygiene to healthcare workers provide additional incentives / motivation – acting in their own self-interest as well as duty of care. Implementing hand hygiene improvement at national and facility level involves managing behaviour and expectations and managing change.

The impact of time at work and time off from work on rule compliance: the case of hand hygiene in health care.

To deliver high-quality, reliable, and consistent services safely, organizations develop professional standards. Despite the communication and reinforcement of these standards, they are often not followed consistently. Although previous research suggests that high job demands are associated with declines in compliance over lengthy intervals, we hypothesized-drawing on theoretical arguments focused on fatigue and depletion-that the impact of job demands on routine compliance with professional standards might accumulate much more quickly. To test this hypothesis, we studied a problem that represents one of the most significant compliance challenges in health care today: hand hygiene. Using longitudinal field observations of over 4,157 caregivers working in 35 different hospitals and experiencing more than 13.7 million hand hygiene opportunities, we found that hand hygiene compliance rates dropped by a regression-estimated 8.7 percentage points on average from the beginning to the end of a typical 12-hr work shift. This decline in compliance was magnified by increased work intensity. Further, longer breaks between work shifts increased subsequent compliance rates, and such benefits were greater for individuals when they had ended their preceding shift with a lower compliance rate. In addition, (a) the decline in compliance over the course of a work shift and (b) the improvement in compliance following a longer break increased as individuals accumulated more total work hours the preceding week. The implications of these findings for patient safety and job design are discussed.

The impact of time at work and time off from work on rule compliance: the case of hand hygiene in health care

'...average compliance rate dropped from 42.6% in the first hour of a shift to 34.8% in the last hour of a typical 12-hr shift'.

Adoption of Improved Goat keeping Practices in Jalaun District of U.P.

Goat rearing is the traditional means of sustaining income, employment and family health among rural poorers. Now days goat rearing is emerge as a beneficial business among farmers. The goats are mostly rear in rainfed and undulated areas of country. Among these areas Bundelkhand region of Uttar Pradesh and their district Jalaun is best suited for goat rearing due to their geographical situation. On this background a study regarding ground realities of goat keepers and goat keeping practices was plan during 2014. For this purpose Jalaun district was purposively selected and datas were collected form 120 goat keepers. The findings of the study show that majority of the goat keepers belong to backward class group. The literacy level was found high with average land holding 1.62 h. Goat rearing contribute about 20 percent contribution in total family income. The flock size was about 18 goats among marginal farmers which was just double from small, medium farmers group. The goat keepers having medium adoption level regarding improved practices of goat rearing. Goat keepers were poor in adopting health care hygiene and breeding related knowledge. The association between extent of adoption and attributes of goat keepers were found independent to each other.

Hand Hygiene in Emergency Medical Services

Background. Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. Methods. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. Results. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. Conclusion. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of their patients to these same organisms. Proper application of accepted standards for hand hygiene can help reduce the presence of microbes on provider hands and subsequent transmission to patients and the environment.

Supplemental Material for The Impact of Time at Work and Time Off From Work on Rule Compliance: The Case of Hand Hygiene in Health Care

Supplemental Material for The Impact of Time at Work and Time Off From Work on Rule Compliance: The Case of Hand Hygiene in Health Care

2.5 Source isolation

British Journal of Healthcare AssistantsVol. 8, No. 4 Clinical2.5 Source isolationMenna Lloyd JonesMenna Lloyd JonesSearch for more papers by this authorMenna Lloyd JonesPublished Online:15 Apr 2014https://doi.org/10.12968/bjha.2014.8.4.173AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (DH) (2009) Isolating patients with healthcare-associated infection. A summary of best practice. http://tinyurl.com/ph9dcvh (accessed 4 March 2014) Google ScholarDepartment of Health (DH), Health Protection Agency (HPA) (2013) Prevention and control of infection in care homes. Summary for staff. http://tinyurl.com/o6pukor (accessed 4 March 2014) Google ScholarDougherty LLister S, eds (2012) Royal Marsden hospital manual of clinical procedures. Student edn. 8th edn. Wiley-Blackwell, London Google ScholarNazarko L (2008) Standard Precautions: how to prevent infection. British Journal of Healthcare Assistants 2(3): 119–23 Link, Google ScholarWorld Health Organisation (WHO) (2009) WHO Guidelines on Hand Hygiene in Health Care. First Global Patient Safety Challenge: Clean Care is Safer Care. www.who.int/gpsc/en/ (accessed 4 March 2014) Google Scholar FiguresReferencesRelatedDetails 1 April 2014Volume 8Issue 4ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 15 April 2014 Published in print 1 April 2014 Information© MA Healthcare LimitedPDF download