Hand hygiene compliance in patients under contact precautions and in the general hospital population

Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza‐González, Elvira; Camacho-Ortíz, Adrián

doi:10.1016/j.ajic.2013.05.003

Cited by 16 publications

(11 citation statements)

References 8 publications

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“…A taxa de adesão de HM verificada por observação direta encontrada na unidade foi maior do que em outros três estudos nacionais que identificaram adesão de 26,5% e 43,7% (8)(9)17) . Essa taxa de adesão é maior que a média geral encontrada em demais áreas hospitalares, e é compatível ou menor do que taxas encontradas em outros estudos que avaliaram a adesão à HM em UTI, ao lidar com pacientes que estavam com e sem precauções de contato (11,(18)(19) .…”

Section: Introductionunclassified

Infraestrutura E Indicadores De Adesão À Higiene Das Mãos Em Unidade De Terapia Intensiva

Castro

Rodrigues

2018

Rev. baiana enferm.

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<p>Objetivo: avaliar a infraestrutura e medir indicadores de adesão à higiene das mãos em Unidade de Terapia Intensiva. Método: estudo de caso descritivo-exploratório, utilizando três instrumentos estruturados para registrar as características dos profissionais, a infraestrutura disponível e a adesão à higiene das mãos. Aplicado teste Quiquadrado. Resultados: as preparações alcoólicas eram insuficientes e as torneiras inadequadas. Foram monitoradas 516 oportunidades de observação e ocorreram 337 ações de higiene das mãos, obtendo-se média de adesão de 65,3%, majoritariamente higiene simples. Existiu diferença da adesão entre os profissionais, com maior taxa dos médicos (77,9%), seguida dos fisioterapeutas (73,8%), enfermeiros (72,1%) e técnicos de enfermagem (57,7%). O momento anterior ao contato com o paciente e antes da realização de procedimentos assépticos apresentaram menor adesão. Evidenciada maior adesão durante a manhã, e sem diferença entre dias da semana. Conclusão: a infraestrutura insuficiente refletiu na baixa adesão à fricção antisséptica.<br />Descritores: Higiene das Mãos. Unidades de Terapia Intensiva. Avaliação em Saúde. Padrão de Cuidado. Segurança do Paciente.</p>

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Section: Introductionunclassified

Infraestrutura E Indicadores De Adesão À Higiene Das Mãos Em Unidade De Terapia Intensiva

Castro

Rodrigues

2018

Rev. baiana enferm.

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“…Previous studies in acute-care settings yielded similar results. 18,25 These findings suggest that focusing efforts on proper precautions during high risk for contamination activities and basic hand hygiene rather than residentdirected activities may be useful. In late 2016, the VA revised its Community Living Center MRSA Prevention Initiative to define certain activities (eg, giving oral medications as "low risk" for transmission) that do not require gowns and gloves, reducing the burden on HCWs.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Isolation on Healthcare Worker Contact and Compliance With Infection Control Practices in Nursing Homes

Pineles¹,

Petruccelli²,

Perencevich

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practiceDESIGNObservational studySETTING AND PARTICIPANTSHealthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and TexasMETHODSOver a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15-30-minute intervals. Observers recorded time of entry and exit, isolation status, visitor type (staff, visitor, etc), hand hygiene, use of gloves and gowns, and activities performed in the room when visible.RESULTSA total of 999 hours of observation were conducted across 8 VA nursing homes during which 4,325 visits were observed. Residents in isolation received an average of 4.73 visits per hour of observation compared with 4.21 for nonisolation residents (P<.01), a 12.4% increase in visits for residents in isolation. Residents in isolation received an average of 3.53 resident care activities per hour of observation, compared with 2.46 for residents not in isolation (P<.01). For residents in isolation, compliance was 34% for gowns and 58% for gloves. Healthcare worker hand hygiene compliance was 45% versus 44% (P=.79) on entry and 66% versus 55% (P<.01) on exit for isolation and nonisolation rooms, respectively.CONCLUSIONSHealthcare workers visited residents in isolation more frequently, likely because they required greater assistance. Compliance with gowns and gloves for isolation was limited in the nursing home setting. Adherence to hand hygiene also was less than optimal, regardless of isolation status of residents.Infect Control Hosp Epidemiol 2018;39:683-687.

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“…Key model parameter estimates are shown in Table 1 . 6 , 10 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ,…”

Section: Methodsunclassified

Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection

et al. 2020

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IMPORTANCE Clostridioides difficile infection is the most common hospital-acquired infection in the United States, yet few studies have evaluated the cost-effectiveness of infection control initiatives targeting C difficile. OBJECTIVE To compare the cost-effectiveness of 9 C difficile single intervention strategies and 8 multiintervention bundles. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation was conducted in a simulated 200-bed tertiary, acute care, adult hospital. The study relied on clinical outcomes from a published agent-based simulation model of C difficile transmission. The model included 4 agent types (ie, patients, nurses, physicians, and visitors). Cost and utility estimates were derived from the literature. INTERVENTIONS Daily sporicidal cleaning, terminal sporicidal cleaning, health care worker hand hygiene, patient hand hygiene, visitor hand hygiene, health care worker contact precautions, visitor contact precautions, C difficile screening at admission, and reduced intrahospital patient transfers. MAIN OUTCOMES AND MEASURES Cost-effectiveness was evaluated from the hospital perspective and defined by 2 measures: cost per hospital-onset C difficile infection averted and cost per quality-adjusted life-year (QALY). RESULTS In this agent-based model of a simulated 200-bed tertiary, acute care, adult hospital, 5 of 9 single intervention strategies were dominant, reducing cost, increasing QALYs, and averting hospital-onset C difficile infection compared with baseline standard hospital practices. They were daily cleaning (most cost-effective, saving $358 268 and 36.8 QALYs annually), health care worker hand hygiene, patient hand hygiene, terminal cleaning, and reducing intrahospital patient transfers.

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Hand hygiene compliance in patients under contact precautions and in the general hospital population

Cited by 16 publications

References 8 publications

Infraestrutura E Indicadores De Adesão À Higiene Das Mãos Em Unidade De Terapia Intensiva

Infraestrutura E Indicadores De Adesão À Higiene Das Mãos Em Unidade De Terapia Intensiva

The Impact of Isolation on Healthcare Worker Contact and Compliance With Infection Control Practices in Nursing Homes

Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection

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