Does hospital ownership influence hand hygiene compliance?

Abstract

The issue as to whether hospital ownership has an impact on the quality of care has long been a serious concern. Hand hygiene (HH) compliance is regarded as an important indicator of the quality of care in the control of hospital-acquired infections. However, little information is available on whether hospital ownership influences HH compliance. In this study, of 229 hospitals selected from Hubei province in China, 152 were public and 77 were private hospitals. A total of 23 652 healthcare workers (HCWs) were surveyed, using a convenience sampling. HH compliance, the WHO's "My Five Moments for hand hygiene" (5MHH), among HCWs, together with the factors of hospital ownership, training frequency, bed occupancy rates, etc. were collected. Univariate analysis and ordinal logistic regression analysis were used to analyze factors affecting HH compliance. Overall, HH compliance rates were 67% and 79% for public and private hospitals, respectively. The HH compliance rates of HCWs and 5MHH were between 55% and 95%, and influenced by hospital ownership (P<0.05), excluding compliance rate at the moment after body fluid exposure, and other influence factors included training frequency and bed occupancy rate (P<0.05). HH compliance is better in private than in public hospitals. Hospital ownership is a significant factor affecting HH compliance, in addition to training frequency and bed occupancy rate.

Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study

“…15,[23][24][25] High workload and facility ownership are additional factors linked with low compliances of hand hygiene as reported by studies in India and China, where low compliance of hand hygiene was noted more frequently in public compared to private facilities. [26][27][28] Although an improvement in hand hygiene compliance was observed in the current study, little improvement was observed in washing hands with water or ABHR for at least 2 minutes and wearing sterile gloves correctly before procedure. The main reason given was absence of previous training, in congruence with results reported by other studies.…”

Hand hygiene in hospitals: an observational study in hospitals from two southern states of India

“…Our finding that compliance to hand hygiene is influenced by facility ownership: better in private than public, has also been reported by a recent study conducted in China. It reported compliance in 77 private and 152 public hospitals with compliance to be significantly better in private than public (79, 67%, p < 0.05) [20].…”

“…In a 2016 study from Rajasthan where primary health care facilities were also included, the hand hygiene compliance during childbirth was 2% in 240 observed cases at baseline [25] which is very low in comparison to our study (34%) that included only secondary and tertiary level facilities. Poor hand hygiene adherence has long been a concern not only in low [17,20,21,25] but also in high resource settings across the globe [8,26] . Hand hygiene compliance is reported as ranging from 8 to 39% in Sub-Saharan African countries [27][28][29].…”

“…Hand hygiene compliance is reported as ranging from 8 to 39% in Sub-Saharan African countries [27][28][29]. The studies from Asian countries report compliance to be ranging between 18 and 46% [20,30,31]. A systematic review of ninety-six studies from industrialized countries reported median compliance rates for intensive care units to be in the range of 30-40% [8].…”

“…Many studies and reports have identified factors affecting compliance. Knowledge of hand hygiene practice, training, availability of essential logistics for maintaining hand hygiene and knowledge of presence of infection prevention committees are the factors that influence hand hygiene compliance [20,[32][33][34] . High workload was mentioned as one of the reasons for non-compliance by 38% of 100 health workers in a study conducted in Pune [35], while another study conducted in a Delhi pediatric intensive care unit observed 100 hand hygiene sessions and reported a decrease in compliance with increased workload [36].…”