No abstract

Background: Hospital acquired infections lead to significant morbidity and mortality in hospitalized patients. Proper implementation of hand hygiene by health care personnel (HCP) prevents nosocomial infections. Objectives: To monitor hand hygiene compliance by the medical and nursing staff in different wards of a children's hospital. Patients and Methods: Four wards were selected for surveillance. In observation periods of 20 minutes each, a trained Pediatric resident observed four patient beds and hand hygiene behavior of health care professionals, physicians (house staff) and nurses, before and after touching the patients. The contacts were classified as 'high-risk' if the person came in contact with body fluids or 'low-risk' if there was no such contact. Findings were documented on a predesigned Hand Hygiene Observation Tool. Results: Overall, 510 patient contacts were observed and 1020 hand hygiene opportunities before and after patient contact were recorded. In total, 302 contacts (59.2%) were low risk and 208 (40.7%) were high risk. The HCP used disposable and surgical gloves before 87, (41.82%) high risk and 27, (8.94%), low risk contacts; however, no hand washing or the use of alcohol hand rubs before contact was recorded by the observer stationed by the patients' bedside. The observer could not ascertain if the HCP washed their hands before entering the 3-6 bedded rooms. Conclusions: Serious lack of adherence to standard protocols for hand hygiene by the HCP together with inappropriate glove use, calls for an urgent strategic planning to educate, train and motivate the health care personnel in all aspects of hand hygiene practices.

Background: Disability is a relatively common problem in children. The pattern of admission in these children and their common infections may differ from other children because of their special disabilities. So we aimed at determination of the common infectious diseases result in admission of these children in our hospital.Methods: During September 2006 to September 2007, 60 disabled children aged between 4 months to 15 years were admitted to infectious ward, Mofid Children Hospital. A questionnaire was filled at admission time; particularly details of their recent complaint, Also children were completely examined. Finally the diagnoses were evaluated. Data were analyzed by SPSS 11.5 Chi-square was used for Qualitative variables.Results: In this study 25 (42%) boys and 35 (58%) girls aged from 4 to168 months were included. Twenty one patients (35%) had developmental, 8 (13%) mental, and 31 (52%) mental and developmental disabilities. The common diseases among these children were lower respiratory tract infection in 24 (40%), urinary tract infections in 8 (13.3%), and nonspecific viral infections in 8 (13.3%). Dental caries and periodontal problems were significantly higher in children with both mental and developmental disabilities, (P = 0.006) this relation was similar in deformity of extremities. Children with both mental and developmental disabilities were admitted more than children with each of them (P = 0.08). Children with both mental and developmental disabilities, and children with developmental disability had more respiratory signs than mentally disabled children (P = 0.02). Conclusion:Although lower respiratory tract infection in 24 (40%) was the most common reason for admission in these children in our study, we found no significant relation between type of disability and infectious disease. We conclude that more prospective studies and trails necessary to complete our findings.