Association Between Hand Hygiene Compliance and Methicillin-Resistant Staphylococcus aureus Prevalence in a French Rehabilitation Hospital

Abstract

We simultaneously investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and compliance with hand hygiene in the clinical wards of a French rehabilitation hospital. We found that the rate of hand hygiene compliance observed at the patient's bedside was a strong predictor of MRSA prevalence.

Hand Hygiene

“…In observational studies conducted in hospitals, HCWs cleaned their hands on average from 5 to as many as 42 times per shift and 1.7-15.2 times per hour (Table I.16.1). 79,137,[217][218][219]262,264,611,613,623,624,[647][648][649][650][651][652][653][654][655] The average frequency of hand hygiene episodes fluctuates with the method used for monitoring (see Part III, Section 1.1) and the setting where the observations were conducted; it ranges from 0.7 to 30 episodes per hour (Table I.16.1). On the other hand, the average number of opportunities for hand hygiene per HCW varies markedly between hospital wards; nurses in paediatric wards, for example, had an average of eight opportunities for hand hygiene per hour of patient care, compared with an average of 30 for nurses in ICUs.…”

“…60,140,215,216,334,335,485,486,492,493,496,497,613,633,637,[648][649][650][651]654,655,657, It should be pointed out that the methods for defining adherence (or non-adherence) and the methods for conducting observations varied considerably in the reported studies, and many articles did not include detailed information about the methods and criteria used. Some studies assessed compliance with hand hygiene concerning the same patient, 60,334,648,652,666,667,683,[685][686][687] and an increasing number have recently evaluated hand hygiene compliance after contact with the patient environment.…”

“…60,217,334,429,485,486,613,648,651,663,666,667,670,680,682,684,686,687,713,714,803,804,851,852 Recent studies have further enriched the scientific literature. 140,428,493,494,655,657,694,698,699,701,705,[707][708][709][710][715][716][717][718]728,853 In general, most studies differed greatly in their duration and intervention approach. Moreover, the outcome measure of hand hygiene compliance varied in terms of the definition of a hand hygiene opportunity and assessment of hand hygiene by means of direct observation 60,217,…”

“…In addition, although not reporting infection rates, several studies showed a sustained decrease of the incidence of multidrug-resistant bacterial isolates and patient colonization following the implementation of hand hygiene improvement strategies. 428,655,687,701 Failure to perform appropriate hand hygiene is considered the leading cause of HCAI and spread of multi-resistant organisms, and has been recognized as a significant contributor to outbreaks.…”

Monitoração da adesão à higienização das mãos: uma revisão de literatura

“…Estudos realizados com base nesta técnica encontraram taxas de adesão entre 7,6% -91,3% (2)(3)(4)(7)(8)(9)14,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . Vale lembrar ainda que mesmo se tratando de estudos observacionais os critérios utilizados em cada estudo variaram consideravelmente, sendo que, em alguns trabalhos, foram observadas as lavagens das mãos apenas antes do contato com o paciente; enquanto outros estudos foram além, observando a adesão durante a assistência inclusive de um mesmo paciente, diferenciando atenção nas áreas mais contaminadas para áreas menos contaminadas do corpo.…”