Hand Hygiene Compliance Not Impacted by Workload, Researchers Discover

High compliance with hand hygiene is a cornerstone of any infection control program; however, a high workload and a lack of time are most commonly used argues against an appropriate compliance. In order to assess the relationship between the hand hygiene events (HHE) and the workload, Scheithauer, et al. (2013) correlated HHEs per patient-day (PD) with the staff time/PD (h), the nursing effort/PD (h) and the C-value indexing the workload, respectively.

All HHEs at a hematology ward (University Hospital Basel, Switzerland) were continuously recorded from 01.03.12 to 28.02.213 using the Ingo-man Weco (Ophardt Hygienetechnik, Issum; Germany) and could be analyzed dispenser-, day-, shift-, localization-specifically. Daily data on patients, staff time (h), nursing effort (h), C-value (1 (nursing effort / weighted staff time)*100) were calculated with regard to the workday from the electronic patient documentation sheets. For statistics, SPSS was used.

During the one year investigation 208.184 HHE translating into 57 (±10) HHE/PD were performed. HHE from Monday to Friday exceeded HHE during the weekends with 59 (±10) versus 51 (±9) /PD. HHE/PD were significantly associated with the staff time with r=0.37 (p=0.01) and with the nursing effort with r=0.41 (p=0.01), respectively. These associations could be verified during workdays as well as during the weekends. In contrary, HHE/PD did not depend on workload in general indexed by the C-value with r=-0.04. However, during Monday and Friday HHE/PD seemed to correlate even inversely with the C-value (r=0.20; p=0.01).

Scheithauer, et al. (2013) concluded that HHE/PD were associated with the staff time and the nursing effort indicating a constant compliance regardless of the workload. This hypothesis was confirmed by the lack of a positive association between the C-value and the HHE/PD. Thus compliance seemed not to be affected by workload at the hematology ward enrolled in this investigation.

Reference: Scheithauer S, Dangel M, Batzer B, Molina CP and Widmer A. Oral presentation O001 at 2013 ICPIC meeting: Getting the unexpected: no association between hand hygiene and workload. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):O1 doi:10.1186/2047-2994-2-S1-O1.