Predictors Of Hand Hygiene Compliance Research Articles

Predictors of hand hygiene attitudes among Saudi healthcare workers of the intensive care unit in Saudi Arabia

Healthcare-associated infections present a challenge to healthcare systems, particularly critical care units. Hand hygiene emerges as a crucial element in infection control, acting as a vital link between healthcare workers, patients, and pathogens. Positive attitudes, motivated by a genuine concern for patient safety, are recognized as major predictors of hand hygiene compliance among healthcare workers. This study aims to assess the attitudes of ICU staff toward hand hygiene and identify factors that influence these attitudes. A cross-sectional survey of intensive care unit staff in seven large Saudi hospitals was conducted using an anonymous, self-reporting questionnaire to examine the attitudes of ICU personnel about hand hygiene and determine the factors that impact these attitudes. A regression analysis was used to determine the determinants of hand hygiene attitudes. Of the 600 respondents, 93% rated their hand hygiene knowledge as good, and 71% received hand hygiene training from their hospital. Most respondents (78%) had previously experienced healthcare-associated infections. The majority reported a favorable overall attitude toward hand hygiene (M = 4.15, SD = 0.85). Attitudes toward hand hygiene were significantly associated with perceived knowledge (β = 0.32, p < 0.001), prior hand hygiene training (β = 0.13, p < 0.05), and years of experience (β = − 0.10, p < 0.05). Healthcare workers in the ICU have a generally positive attitude toward hand hygiene. Such attitudes were correlated with hand hygiene knowledge, prior training, and job experience. The study’s findings can help to inform health promotion initiatives and campaigns aimed at achieving long-term improvements in hand hygiene behaviors.

Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study.

The study aimed to evaluate the efficacy of the World Health Organization (WHO) multimodal hand hygiene improvement (WHO-5) strategy in enhancing hand hygiene compliance among health care workers at a tertiary care hospital. The interrupted time series study included preintervention, intervention, and postintervention phases, with 2 points of observation each during the pre- and postintervention phases. The baseline hand hygiene compliance was 16%, which improved to 43.9% after the intervention. Health care workers were 4 times more likely to adhere to proper hand hygiene postintervention (odds ratio [OR], 4.117). Independent predictors of hand hygiene compliance included the week of observation (week 3: adjusted odds ratio [AOR], 0.872; week 5: AOR, 3.427; and week 7: AOR, 4.713), health care worker type (consultants: AOR, 0.964; residents: AOR, 2.187; and interns: AOR, 6.684), daytime (AOR, 1.232), and "after" type of hand hygiene opportunity (AOR, 1.577). No significant differences were found in knowledge, attitude, and practices pre- and postintervention, and the interventions' effect was sustained and increased over time, supporting implementation in hospitals across India.

Compliance with hand-hygiene guidelines among healthcare workers: a cross-sectional study at the Umberto I teaching hospital of Rome, Italy.

Healthcare-associated infections are often associated with poor hand hygiene (HH) by healthcare workers (HCWs). The objective of this cross-sectional study at the Umberto I teaching hospital in Rome was to quantify compliance with HH by direct observation following a multimodal strategy devised by the World Health Organisation and to map critical areas for improvement. Predictors of HH compliance were identified using a multivariable logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Eighty-four trained observers from 50 wards collected 4,081 observations showing that overall HH compliance was 71.9%. The multivariable analysis found a positive association with the outcome for midwives compared to physicians (aOR=2.5, 95% CI: 1.5-4.1), and a negative association for healthcare assistants (aOR=0.5, 95% CI: 0.3-0.8). There was greater compliance during public holidays and weekends (aOR=1.5, 95% CI: 1.1-2.1), but compliance was lower for external staff (aOR=0.7, 95% CI: 0.5-0.9). We found a positive association with all HH indications after interaction with a patient or with patient surroundings compared with the indication "before touching a patient" (all p<0.001); the highest association was with the indication "after contact with biological fluids" (aOR=7.7, 95% CI: 4.7-12.5). Overall, we observed reasonable compliance levels, but it is important to increase adherence to HH practice and monitor any behaviour change.

Observational assessment of hand hygiene compliance among healthcare workers in public hospitals of Northeastern Ethiopia

ABSTRACT This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6–48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2–2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3–5.4), work overload (AOR = 2.5; 95%CI: 1.9–4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1–4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2–4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5–4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals’ managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.

Predictors of Compliance to Hand Hygiene among Health Care Workers in Rwanda

BackgroundHand hygiene is critical to the prevention of Healthcare Acquired Infections. Compliance of health care workers to hand hygiene in developing countries is reportedly low.ObjectiveThe aim of this study was to assess predictors of hand hygiene compliance among healthcare workers in RwandaMethodsThis cross-sectional study was conducted in 26 selected hospitals. Trained hospital IPC focal points anonymously observed 1380 hand hygiene opportunities from 341 healthcare workers. Logistic regression analysis was used to identify predictors of compliance to hand hygiene among health care workers using Stata.ResultsThe overall compliance to HH was 72.4%. It was respectively 70%, 77% and 60% less likely in labor (AOR=0.30, 95% CI: 0.19-0.49), maternity (AOR= 0.27, 95% CI: 0.17-0.43), and neonatology (AOR= 0.40 95% CI: 0.25-0.65) departments than in theater. Other clinical staff than nurses/midwives were 35% less likely to comply than did medical doctors. The availability of water source and soap at hand washing station was associated with 2.5 times higher odds of compliance (AOR=2.46, 95% CI: 1.27-4.77).ConclusionThe compliance to HH is associated with the availability of hand hygiene facilities. Well-maintained water sources and soap at hand washing stations should be a priority in health care settings.&#x0D; Rwanda J Med Health Sci 2022;5(2):170-179

Hand hygiene compliance and its associated factors among health care providers in primary hospitals of Waghimira Zone, Northeast Ethiopia: a mixed study design

IntroductionHand hygiene compliance is the problem of developing nations particularly in Sub-Saharan Africa including Ethiopia. Despite a lot of efforts have been employed, healthcare-associated infections are the existing health care problems, leading to impaired quality of life, prolonged hospital stays, increased healthcare costs, morbidity and mortality. This study aimed to assess the magnitude and factors associated with hand hygiene compliance among health care providers working at the primary hospitals of Waghimira Zone, Northeast Ethiopia.MethodsFacility-based cross-sectional study design supplemented with qualitative research method was employed at the primary hospitals of Waghimira Zone from March 02–15, 2020. Simple random sampling using lottery method was applied to select 253 study participants. The data were coded on pre-arranged coding sheet and entered into Epi-Data version 3.1 and exported to SPSS version 25 for analysis. Descriptive statistics were displayed using tables and figures. Binary logistic regression analysis was used to test associations between the independent and the outcome variable. Multivariable logistic regression analysis was fitted to identify the independent predictors of hand-hygiene compliance at p-value < 0.05 and AOR with 95% confidence interval. Six Key Informant Interviews were conducted with purposively selected chief executive and clinical officers. Thematic content analysis was made and the findings were written sequentially with explanatory method.ResultsOne-fifth of the subjects (20.6%, 95% CI = 15.2, 24.9) had good hand hygiene compliance. Attended training on hand hygiene protocol (AOR = 3.18, 95% CI: 1.39, 7.28), accessible to adequate soap and water (AOR = 3.77, 95%CI: 1.52, 9.37), having alcohol for hand rub (AOR = 2.67, 95%CI: 1.18, 6.05) and having hand wash sink (AOR = 2.31, 95%CI: 1.03, 5.14) were significantly associated with hand hygiene compliance which also supported by the qualitative findings.ConclusionsHand hygiene compliance among health care providers was low in the study area. Attended training on hand hygiene, accessibility to adequate soap and water, alcohol-based hand rub, and having hand washing sink in working area were statistically significant. Hence, the primary hospitals should be equipped with adequate supply to all the basic hand hygiene facilities.

Level of Hand Hygiene Compliance and Its Associated Factors Among Health Care Workers at Eka Kotebe General Hospital, Addis Ababa, Ethiopia.

Background:Poor hand hygiene is an important source of infection, but maintaining hand hygiene is the most important measure to prevent infections. Hand hygiene compliance and its associated factors are not well recognized in Ethiopia. Therefore, this study was intended to determine hand hygiene compliance and its associated factors among health care workers in Eka Kotebe General Hospital.Methods:A cross-sectional study was conducted among health care workers at Eka Kotebe General Hospital. A self-administered questionnaire supplemented by a World Health Organization Hand Hygiene Technical Reference Manual was used to collect data. Data was entered using Epi Info 7.2.0.1 and exported to SPSS 23 for analysis. The data were analyzed using descriptive and inferential statistics. Statistical significance was determined using a P-value of ⩽.05 with a 95% confidence interval.Results:Hand hygiene compliance among healthcare workers was 22.2%. Hand hygiene training (AOR = 2.9, 95% CI: 1.13-7.52), presence of hand hygiene indication poster (AOR = 3.38, 95% CI: 1.18-9.66), hand hygiene promotion by IPC team (AOR = 4.2, 95% CI: 2.53-8.58)), working experience ⩾5 years of a health care providers (AOR = 3.96, 95% CI: 1.12-13.9), being midwife (AOR = 17.1, 95% CI: 2.8-10), being nurse (AOR = 5.3, 95% CI: 2.09-7.8) by profession, and presence of water (AOR = 2.50, 95% CI: 2.20-11.78) were significantly associated factors to hand hygiene compliance.Conclusion:The level of hand hygiene compliance among health care providers was found to be low. Training about hand hygiene, the presence of hand hygiene indication posters, hand hygiene promotion by the IPC team, working experience of health care providers, being a nurse and midwife, and the presence of water were independent predictors of hand hygiene compliance. Health care workers need to be given training on hand hygiene as well as hand hygiene facilities shall be installed and supplied by the hospital in a sustained manner.

What are the predictors of hand hygiene compliance in the intensive care unit? A cross-sectional observational study.

Background:Although appropriate hand hygiene (HH) practices are recognised as the most effective preventative strategy for infection, adherence is suboptimal. Previous studies in intensive care units (ICUs) have found differences in HH compliance between those moments that protect the patient, and those that protect the healthcare provider. However, such studies did not control for other variables known to impact HH compliance.Aim:To examine HH among healthcare workers (HCWs) in ICU settings, and identify whether there is a statistical difference in HH compliance between patient-protective and self-protective moments, while controlling for other variables known to influence HH compliance (i.e. professional role, unit and shift time).Methods:A cross-sectional observational study was conducted in four ICUs across three Irish hospitals. Compliance was assessed according to the WHO’s ‘five moments for hand hygiene’. HCW professional role, total number of ‘opportunities’ for HH and whether compliance was achieved were recorded.Results:A total of 712 HH opportunities were recorded, with an overall compliance rate of 56.9%. Logistic regression analysis revealed that physicians, allied healthcare professionals and auxiliary staff were less likely than nurses to engage in HH. HCWs were more likely to comply during night shifts compared to morning shifts, and with self-protective as compared to patient-protective HH moments.Conclusion:The information provided in this study provides a data-driven approach that ICUs can use to tailor HH interventions to where, when and for whom they are most required.

Self-perceived hand hygiene practices among undergraduate nursing students

Abstract Limited research has investigated the hand hygiene practices of undergraduate nursing students. A descriptive self-report survey explored the predictors of self-perceived hand hygiene compliance using a convenience sample of 306 undergraduate nursing students enrolled at a southwestern Ontario university. Compliance was defined as the performance of hand hygiene at least 90% of the time in the moments both before and after direct patient contact. The self-reported compliance rate among study participants was 74.8%. Logistic regression analysis revealed that the independent predictors of hand hygiene compliance included concern about reprimand or discipline (odds ratio (OR) 4.324; 95% confidence interval (CI) 1.465–12.758); motivation to protect patients from infection (OR 2.418; 95% CI 1.001–5.838); number of clinical placements (OR 0.815; 95% CI 0.702–0.947) and role modelling by the clinical instructor (OR 2.227; 95% CI 1.009–4.915). Other independent predictors were the perceived barriers of busyness (OR 0.231; 95% CI 0.126–0.423), forgetfulness (OR 0.356; 95% CI 0.186–0.678) and perceptions of alcohol rub-related skin damage (OR 0.163; 95% CI 0.070–0.380). The findings of this study provide research-based evidence that could be used by educators to understand better hand hygiene practices among undergraduate nursing students.

Hand Hygiene Compliance in an Emergency Department: The Effect of Crowding.

Emergency department (ED) crowding results from the need to see high volumes of patients of variable acuity within a limited physical space. ED crowding has been associated with poor patient outcomes and increased mortality. The authors evaluated whether ED crowding is also associated with reduced hand hygiene compliance among health care workers. A trained observer measured hand hygiene compliance using standardized definitions for 22 months in the 40-bed ED of a 475-bed academic hospital in Toronto, Ontario, Canada. ED crowding measures, including mean daily patient volumes, time to initial physician assessment, and daily nursing hours, were obtained from hospital administrative and human resource databases. Known predictors of hand hygiene compliance, including the indication for hand hygiene and the health care workers' professions, were also measured. Hand hygiene data, measured during 20-minute observation sessions, were linked to aggregate daily results for each crowding metric. Crowding metrics and known predictors of hand hygiene compliance were then included in a multivariate model if associated with hand hygiene compliance at a p-value of <0.20. Hand hygiene compliance was 29% (325 of 1,116 opportunities). Alcohol-based hand rinse was used 66% of the time. Nurses accounted for 68% of hand hygiene opportunities and physicians for 18%, with the remaining 14% attributed to nonphysician, nonnurse health care workers. The most common indications for hand hygiene were hand hygiene prior to (35%) and hand hygiene following (52%) contact with the patient or his or her environment. In multivariate analysis, time to physician assessment>1.5 hours was associated with lower compliance (odds ratio [OR]= 0.67, 95% confidence interval [CI] =0.51 to 0.89). Additionally, compliance was lower for nonnurse, nonphysician health care workers (OR= 0.51, 95% CI=0.33 to 0.79) and higher for hand hygiene performed after contact with the patients or his/her environment, compared to hand hygiene performed before contact with the patient or his/her environment (OR= 2.0, 95% CI=1.5 to 2.7). Daily patient volumes and nursing hours were not associated with hand hygiene compliance. ED hand hygiene compliance was low. Increased time to physician assessment was associated with reduced compliance, suggesting an association between crowding and compliance. Strategies that minimize ED crowding may improve ED hand hygiene compliance.

244: Environmental Predictors of Hand Hygiene Compliance in the Emergency Department

Health care worker (HCW) hand hygiene (HH) prevents health care-associated infections, and studies show that environmental factors such as room visibility and availability of handwashing stations affect HH compliance. Little is known about how the unique emergency department (ED) work environment affects HH compliance. We aimed to determine the predictive value of HH opportunity characteristics, ED layout, and ED crowding on HH.