Influence of Handprint Culture Training on Compliance of Healthcare Workers with Hand Hygiene

Abstract

Objective We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers' (HCWs) compliance with hand hygiene (HH). Settings Medical and postoperative cardiac surgery units. Design Prospective cohort study. Subject The study included 40 HCWs. Intervention Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results There was a significant improvement in HH compliance following handprint culture interview (p < 0.001). The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p = 0.001; wound cultures: p = 0,003; sputum cultures: p = 0.005). Conclusion The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.

Hand hygiene compliance and improvement interventions in the Eastern Mediterranean Region: a systematic review and meta-analysis

“…The characteristics of the 19 interventional studies are shown in Table II . Of these studies, three were RCTs [ [43] , [44] , [45] ], four were interrupted time series [ [46] , [47] , [48] , [49] ],12 were quasi-experimental studies, and one of them was a multicenter study [ [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] ] Pakistan, Saudi Arabia [KSMC] and Saudi Arabia [KAMC] . The study duration ranged from 10 days [ 48 ] to five years [ 47 ].…”

“…The intervention was performed in different departments of the hospital. The highly sensitive areas were ICU units [ 45 , 46 , 51 , 52 , [54] , [55] , [56] , [57] , 59 , 60 ], [ 61 ] Pakistan, Saudi Arabia [KSMC] and Saudi Arabia [KAMC] and surgical wards [ 45 , 51 , 59 ], [ 61 ] Pakistan, Saudi Arabia[KSMC] and Saudi Arabia [KAMC] , while the less sensitive areas were medicine [ 45 , 51 , 52 , 59 ], [ 61 ] Pakistan , emergency [ 51 , 59 ], oncology [ 45 , 48 , 61 ] Pakistan and Saudi Arabia[KSMC] , gynecology and obstetrics [ 44 , 61 ] Pakistan and Saudi Arabia[KSMC] , pediatrics [ 51 , 61 ] Saudi Arabia[KSMC] , and others [ 50 , 51 , 56 , 60 ]. Three studies included all hospital departments [ 47 , 49 , 53 ], while two did not mention study departments [ 44 , 58 ].…”

“…Three studies included all hospital departments [ 47 , 49 , 53 ], while two did not mention study departments [ 44 , 58 ]. Several studies were conducted in different countries: 10 in Saudi Arabia [ [46] , [47] , [48] , 50 , 53 , 55 , 56 , 58 ], [ 61 ] Saudi Arabia[KSMC] and Saudi Arabia [KAMC] , one in Pakistan [ 61 ] Pakistan , one in Tunisia [ 51 ], two in Egypt [ 52 , 54 ], one in Kuwait [ 57 ], one in Qatar [ 49 ], three in Iran [ 43 , 44 , 59 ], one in the UAE [ 60 ], and one in Lebanon [ 45 ].…”

“… Motivate the stakeholders to be involved in creating an environment that promotes and encourages patient safety, seeking the support of all HCWs. 56% H (80%) Fouad el at, (2018) [ 52 ] Egypt Pre-post intervention All HCWS Medical and cardiac PICU Handprint culture 3 months Handprints cultures were collected form HCWs before and after HH compliance 43% L (40%) Farhoudi et al. (2016) [ 59 ] Iran Quasi-experiment Nurses Medical, emergency, internal, PICU, and surgical WHO strategy 12 months System change to ensure access of healthcare workers to HH facilities with emphasis on availability of ABHR formulations at the point of care Ongoing training and education Evaluation of practices and feedback Reminders at the workplace Providing a climate of safety through institution Female ward 6% Male ward 8% L (40%) Harrabi et al.…”

“…Two studies implemented educational programs [ 43 , 44 ]. Six studies implemented different interventions, such as handprint culture [ 52 ], giving feedback as compared to giving incentives [ 45 ], diverse activities [ 48 , 53 ], global hand sanitizing relay challenge [ 58 ], and identification barrier interview-based program [ 44 ]. Detailed descriptions of the results are provided in the Supplementary file A ( Table A2 ).…”