scholarly journals Appropriate Number of Observations For Determining Hand Hygiene Compliance Among Healthcare Workers

2021 ◽  
Author(s):  
Se Yoon Park ◽  
Suyeon Park ◽  
Eunjung Lee ◽  
Tae Hyong Kim ◽  
Sungho Won
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
Hygiene Compliance ◽  
Health Organization

Abstract We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (CI) (1-α) [The equation: n ≥ Z2 α/2 * p * (1-p)/d2 ]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8,791 HH opportunities among 1,168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 (d: 30%, CI: 90%) to 624 (d: 5%, CI: 99%), and that for optimal HH compliance ranged from 5 (d: 30%, CI: 90%) to 642 (d: 5%, CI: 99%). We found that at least five observations were needed to determine optimal HH compliance with 30% absolute precision and a 90% CI.

scholarly journals Appropriate number of observations for determining hand hygiene compliance among healthcare workers

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Se Yoon Park ◽  
Suyeon Park ◽  
Beom Seuk Hwang ◽  
Eunjung Lee ◽  
Tae Hyong Kim ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
Hygiene Compliance ◽  
Health Organization

AbstractWe sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (ρ), absolute precision (d), and confidence interval (CI) (1 − α) [the equation: $${\text{n}} \ge Z_{\alpha /2}^{2} \times \rho \times \left( {1 - \rho } \right)/d^{2}$$ n ≥ Z α / 2 2 × ρ × 1 - ρ / d 2 ]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8791 HH opportunities among 1168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 ($$d$$ d : 30%, CI: 90%) to 624 ($$d$$ d : 5%, CI: 99%), and that for optimal HH compliance ranged from 5 ($$d$$ d : 30%, CI: 90%) to 642 ($$d$$ d : 5%, CI: 99%). Therefore, we found that our hospital required at least five observations to determine optimal HH compliance.

scholarly journals Appropriate Number of Observations to Determine Hand Hygiene Compliance Among Healthcare Workers

2021 ◽  
Vol 1 (S1) ◽  
pp. s64-s64
Author(s):  
Se Yoon Park ◽  
Eunjung Lee ◽  
Suyeon Park ◽  
Tae Hyong Kim ◽  
Sungho Won
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Mean Value ◽  
World Health ◽  
The World ◽  
Minimum Number ◽  
The Mean ◽  
Hygiene Compliance ◽  
Health Organization

Background: We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. Methods: The study was conducted at a referral hospital. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Appropriate HH compliance rates were calculated based on the 6-step technique, modified from the World Health Organization (WHO) recommendation. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (1-α) [The equation: n3 Zα/22×ρ×1-ρ/d2]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%, respectively. Among the various cases, we focused on 10% for d and 95% for CI. Results: During the study period, 8,791 opportunities among 1,168 healthcare workers were monitored. The mean HH compliance and appropriate HH compliance rates were 80.3% and 59.7%, respectively (Table 1). The minimum number of observations required to determine HH compliance rates ranged from 2 (d, 30%; CI, 90%) to 624 (d, 5%; CI, 99%), and the minimum number of observations for optimal HH compliance ranged from 5 (d, 30%, CI, 90%) to 642 (d, 5%; CI, 99%) (Figure 1). At 10% absolute precision with 95% confidence, the minimum number of observations to determine HH and optimal HH compliance were 61 and 92, respectively. Conclusions: The minimum number of observations to determine HH compliance varies widely according to setting, but at least 5 were needed to determine optimal HH compliance.Funding: NoDisclosures: None

scholarly journals “The Dirty Hand in the Latex Glove”: A Study of Hand Hygiene Compliance When Gloves Are Worn

2011 ◽  
Vol 32 (12) ◽  
pp. 1194-1199 ◽  
Author(s):  
Christopher Fuller ◽  
Joanne Savage ◽  
Sarah Besser ◽  
Andrew Hayward ◽  
Barry Cookson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
The Elderly ◽  
World Health ◽  
Risk Level ◽  
Latex Glove ◽  
Type Contact ◽  
Hygiene Compliance ◽  
Health Organization

Background and Objective.Wearing of gloves reduces transmission of organisms by healthcare workers' hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used nonstandardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn.Design.Observational study.Participants and Setting.Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales.Methods.We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts.Results.Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]; P<.0001).Conclusion.The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene.Trial Registration.National Research Register N0256159318.

scholarly journals Improving Hand Hygiene Compliance in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial (HANDSOME Study)

10.2196/17419 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17419 ◽  
Author(s):  
Gwen R Teesing ◽  
Vicki Erasmus ◽  
Mariska Petrignani ◽  
Marion P G Koopmans ◽  
Miranda de Graaf ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Disease Incidence ◽  
Controlled Trial ◽  
World Health ◽  
The World ◽  
Hygiene Compliance ◽  
Cluster Randomized

Background Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care–associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods Nursing homes were randomly allocated to 1 of 3 trial arms: receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization’s 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing home environment. Nurses were taught the World Health Organization’s 5 moments of hand hygiene guidelines using the slogan “Room In, Room Out, Before Clean, After Dirty,” which was developed for nursing staff to better understand and remember the hygiene guidelines. HANDSOME should contribute to improved hand hygiene practice and a reduction in infectious disease rates and related mortality. Trial Registration Netherlands Trial Register (NTR6188) NL6049; https://www.trialregister.nl/trial/6049 International Registered Report Identifier (IRRID) DERR1-10.2196/17419

scholarly journals Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity

2018 ◽  
Vol 19 (3) ◽  
pp. 116-122 ◽  
Author(s):  
A Jeanes ◽  
J Dick ◽  
P Coen ◽  
N Drey ◽  
DJ Gould
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Care Delivery ◽  
Compliance Rate ◽  
Significant Risk ◽  
World Health ◽  
Compliance Monitoring ◽  
Infection Control Practitioner ◽  
Hygiene Compliance ◽  
Health Organization

Background: Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low. Aims: To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance. Methods: The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool. Findings: In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk. Discussion: We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty.

scholarly journals Hand hygiene compliance among rural healthcare workers of Nepal

2018 ◽  
Vol 5 (1) ◽  
pp. 90-95
Author(s):  
Ajay Kumar Rajbhandari ◽  
Reshu Agrawal Sagtani ◽  
Kedar Prasad Baral
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Compliance Rate ◽  
Hand Washing ◽  
World Health ◽  
Cross Sectional ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).

scholarly journals Identifying the World Health Organization’s fifth moment for hand hygiene: Infection prevention in the operating room

2019 ◽  
Vol 21 (1) ◽  
pp. 28-34
Author(s):  
Fiona Smith ◽  
Karen Lee ◽  
Eleanor Binnie-McLeod ◽  
Mark Higgins ◽  
Elizabeth Irvine ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Operating Room ◽  
Direct Contact ◽  
Phase 1 ◽  
World Health ◽  
Phase 2 ◽  
Frontline Staff ◽  
The World ◽  
Hygiene Compliance ◽  
Health Organization

Background: The World Health Organization have designed the fifth of their ‘5 moments’ for hand hygiene to account for microbial transfer from patients to equipment in a narrow area around that patient, known as the patient zone. The study was prompted by emerging local confusion about application of the patient zone in the operating room (OR). Aim/Objectives: In two phases, we aimed to create a ‘5 moments’ style poster displaying an OR patient zone: phase 1, quantify equipment, in direct contact with the patient and, touched by non-scrubbed staff immediately after touching the patient; and phase 2, categorise equipment identified in phase 1 into patient zone and healthcare zone. An objective is to produce a ‘5 moments’ poster for the OR. Methods: The first phase used non-participant direct overt observation. In phase 2, phase 1 data were collaboratively assigned to patient zone or healthcare zone. Photography and graphic design were used to produce the OR ‘5 moments’ poster. Results: In 11 full-length surgeries, 20 pieces of equipment were in direct contact with the patient and 57 pieces of equipment were touched. In phase 2, a ‘5 moments’ poster showing an OR patient zone was designed. Discussion: Content of the patient zone was identified and displayed in a novel resource. Having shared understanding of the patient zone has potential to sustain hand hygiene compliance and equipment cleaning in the OR. Conclusion: Limitations in methods were balanced by collaboration with frontline staff. The study has been used as a teaching tool in the OR and similar settings.

scholarly journals Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

2017 ◽  
Vol 22 (23) ◽  
Author(s):  
Maria Luisa Moro ◽  
Filomena Morsillo ◽  
Simona Nascetti ◽  
Mita Parenti ◽  
Benedetta Allegranzi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Absolute Increase ◽  
Italian Regions ◽  
Hygiene Promotion ◽  
Before And After ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Implementation Progress

A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.

scholarly journals A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance

2019 ◽  
Vol 40 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Manon D. van Dijk ◽  
Sanne A. Mulder ◽  
Vicki Erasmus ◽  
A. H. Elise van Beeck ◽  
Joke M. J. J. Vermeeren ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Intervention Program ◽  
World Health ◽  
Time Points ◽  
Multimodal Intervention ◽  
Hygiene Compliance ◽  
Friendly Competition ◽  
Time Point

AbstractObjectiveTo investigate the effects of friendly competition on hand hygiene compliance as part of a multimodal intervention program.DesignProspective observational study in which the primary outcome was hand hygiene compliance. Differences were analyzed using the Pearson χ2 test. Odds ratios (ORs) with 95% confidence interval were calculated using multilevel logistic regression.SettingObservations were performed in 9 public hospitals and 1 rehabilitation center in Rotterdam, Netherlands.ParticipantsFrom 2014 to 2016, at 5 time points (at 6-month intervals) in 120 hospital wards, 20,286 hand hygiene opportunities were observed among physicians, nurses, and other healthcare workers (HCWs).InterventionThe multimodal, friendly competition intervention consisted of mandatory interventions: monitoring and feedback of hand hygiene compliance and optional interventions (ie, e-learning, kick-off workshop, observer training, and team training). Hand hygiene opportunities, as formulated by the World Health Organization (WHO), were unobtrusively observed at 5 time points by trained observers. Compliance data were presented to the healthcare organizations as a ranking.ResultsThe overall mean hand hygiene compliance at time point 1 was 42.9% (95% confidence interval [CI], 41.4–44.4), which increased to 51.4% (95% CI, 49.8–53.0) at time point 5 (P<.001). Nurses showed a significant improvement between time points 1 and 5 (P<.001), whereas the compliance of physicians and other HCWs remained unchanged. In the multilevel logistic regressions, time points, type of ward, and type of HCW showed a significant association with compliance.ConclusionBetween the start and the end of the multimodal intervention program in a friendly competition setting, overall hand hygiene compliance increased significantly.

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