HH Compliance Requires Continual Assessment and Education

Healthcare workers hands play a crucial role in the transmission of microorganisms. Therefore, hand hygiene is acknowledged as one of the most effective measures to prevent healthcare-associated infection. However many factors interfere with this simple preventive action; some are related to tools and others are in direct relation to behavioral incompetence of healthcare workers.

Khamis reports on a study conducted in a 1,000-bed university hospital in Cairo, Egypt. An infection control system has been in use since 1989, and hand hygiene is one of the policies implemented in all hospital departments. Since 2008, a system change from handwashing to alcohol-based hand rub was followed. Tools were provided in the form of WHO guidelines, educational materials and supplies as well as alcohol-based products (dispensers and pocket bottles). On-the-job training and follow-up was conducted to embed the new concept of hand hygiene and to measure the compliance among nurses and doctors.

Two hand hygiene campaigns were conducted in 2009 and 2010. The former was for two weeks and assessment using the WHOs Five Moments designed observation sheet was used to measure the compliance. The latter was for one week using the first moment observation sheet of WHOs Five Moments.

For 2009, compliance was manually calculated in six departments and it ranged from 10.8 percent to 89 percent for moment one, 4 percent to 100 percent for moment two, 86 percent to 100 percent for moment three, 70.9 percent to 100 percent for moment four, and for moment five 61 percent to 100 percent.  In 2010, calculation of compliance for moment one was 48.91 percent in five medical departments.

Khamis concludes that integration of hand hygiene in healthcare worker behavior requires a long-term, persistent educational program as well as continuous assessment of the level of knowledge. Regular awareness courses for nurses and doctors and provision of tools as alcohol-based products are reccomended to help change behavior. The research was presented at the International Conference on Prevention & Infection Control (ICPIC) held in Geneva, Switzerland June 29-July 2, 2011.

Reference: Khamis N. Integration of hand hygiene in healthcare workers behavior. Presentation at International Conference on Prevention & Infection Control (ICPIC). BMC Proceedings 2011, 5(Suppl 6):P106doi:10.1186/1753-6561-5-S6-P106.