Researchers Observe Low Levels of Hand Hygiene Compliance in Pediatric Hospitals

Hand hygiene (HH) is one of the basic components of the infection control program. The use of a waterless, alcohol-based hand rub (ABHR) is more effective, saves time and promote better compliance than handwashing, according to Kouni et al. (2013), who sought to estimate the current HH practices in order to schedule the future interventions.

Observational HH data were collected from 13 wards in two pediatric hospitals in Athens, including medical/surgical, oncology/transplant (BMTU), and intensive care units (ICUs), during 65 one-hour observations periods, from October 2012 to January 2013. HH opportunities and attempts were designated as appropriate or inappropriate per WHO criteria.

A total of 1,271 HH opportunities were identified during the observation period. Overall HH compliance was 33 percent (417/1271) of which 58.8 percent were appropriate. Compliance differed by role: nurses (49 percent), physicians (24 percent) and others (19 percent) (p0.001). Healthcare workers (HCWs) and visitors were more likely to use soap and water (76.1 percent) compared to ABHR (23.9 percent) and no significant difference was detected among these groups (p=0.330). In regards to type of department, the use of ABHR was found to be strongly higher in surgical wards (71.8 percent) compared to the rest of wards which this rate ranges from 11.1 percent in NICUs to 33.3 percent in emergency departments (p<0.001). The HH procedure was appropriate in 63.4 percent and 45.4 percent among those used soap and water and ABHR, respectively (p=0.002). The most commonly identified HH opportunities were after child contact (381), before child contact (376), after contact with childs surroundings (358) and before aseptic procedure (95). Despite the fact that all HCWs use more often handwashing, a minor number of HH opportunities (61) were identified after contact with body fluids, the step of HH which demands this HH method.

The researchers concluded that a low level of HH compliance and use of ABHR was observed. The education of the appropriate use of ABHR must be the main intervention for hand hygiene in these healthcare facilities.

Reference: S Kouni, K Mougkou, G Kurlaba, C Nteli, A Lourida, S Maroudi-Manta, T Zaoutis and S Coffin. Poster presentation P130 presented at the 2nd International Conference on Prevention and Infection Control (ICPIC 2013): Assessment of hand hygiene practices at the two children's hospitals in Greece. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P130 doi:10.1186/2047-2994-2-S1-P130