Measurement and interpretation of hand hygiene compliance rates: importance of monitoring entire care episodes

Eveillard, Matthieu; Hitoto, Hikombo; Raymond, Françoise; Kouatchet, Achille; Dubé, Laurent; Guilloteau, Véronique; Pradelle, Marie-Thérèse; Brunel, Patrick; Mercat, Alain; Joly-Guillou, Marie-Laure

doi:10.1016/j.jhin.2009.03.025

Cited by 41 publications

(33 citation statements)

References 23 publications

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“…7 HCWs care for many patients simultaneously and may serve as vectors in HAI transmission between patients. 8 Patients have contact with many different HCWs, but limited information exists about how often, by whom, and to what degree patients are touched. A study conducted in a neonatal ICU suggests that nurses make more than half of all patient contacts and are most likely to touch patients’ skin and body fluids.…”

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confidence: 99%

Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention

Cohen

Hyman

Rosenberg

et al. 2012

The Joint Commission Journal on Quality and Patient Safety

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Article-at-a-Glance Background Contact with health care workers may be an important means of infection transmission between patients, yet little is known about patterns of patient contact with staff and visitors in hospitals. In a cross-sectional study, the frequency, type, and duration of contacts made by health care workers, other hospital staff, and visitors to patients in acute care settings were documented. Methods Patients were observed in seven units of three academic hospitals, with recording of each occurrence of someone’s entry into the patient’s room. The health care worker’s role, the duration of the visit, and the highest level of patient contact made were noted. Staff were also surveyed to determine their perception of how many patients per hour they come into contact with, how long they spend with patients, and the level of patient contact that occurs. Findings Hourly room entries ranged from 0 to 28 per patient (median, 5.5), and patients received visits from 0 to 18 different persons per hour (median, 3.5). Nurses made the most visits (45%), followed by personal visitors (23%), medical staff (17%), nonclinical staff (7%), and other clinical staff (4%). Visits lasted 1 to 124 minutes (median, 3 minutes for all groups). Persons entering patients’ rooms touched nothing inside the room, only the environment, the patient’s intact skin, or the patient’s blood/body fluids 22%, 33%, 27%, and 18% of the time, respectively. Medical staff estimated visiting an average of 2.8 different patients per hour (range, 0.5–7.0), and nursing staff estimated visiting an average of 4.5 different patients per hour (range, 0.5–18.0). Conclusions Examining patterns of patient contact may improve understanding of transmission dynamics in hospitals. New transmission models should consider the roles of health care workers beyond patients’ assigned nurses and physicians.

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confidence: 99%

Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention

Cohen

Hyman

Rosenberg

et al. 2012

The Joint Commission Journal on Quality and Patient Safety

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“…Most research studies evaluating the effectiveness of educational campaigns to promote hand hygiene practices focus on the compliance of healthcare staff, which has been found to be variable (Thompson et al 1997; Pittet et al (Creedon et al 2008) with perversely worse compliance in intensive care units (ICU; Pittet et al 1999b;Eveillard et al 2009). …”

Section: Practice Pointsmentioning

confidence: 99%

Features of educational interventions that lead to compliance with hand hygiene in healthcare professionals within a hospital care setting. A BEME systematic review: BEME Guide No. 22

et al. 2012

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Background: In the United Kingdom, there are approximately 300,000 healthcare-associated infections (HCAI) annually, costing an estimated £1 billion. Up to 30% of all HCAI are potentially preventable by better application of knowledge and adherence to infection prevention procedures. Implementation of Department of Health guidelines through educational interventions has resulted in significant and sustained improvements in hand hygiene compliance and reductions in HCAI. Aim: To determine the features of structured educational interventions that impact on compliance with hand hygiene in healthcare professionals within a hospital care setting. Methods: Sixteen electronic databases were searched. Outcomes were assessed using Kirkpatrick's hierarchy and included changes in hand hygiene compliance of healthcare professionals, in service delivery and in the clinical welfare of patients involved. Results: A total of 8845 articles were reviewed, of which 30 articles met the inclusion criteria. Delivery of education was separated into six groups. Conclusions: It was not possible to identify individual features of educational interventions due to each study reporting multicomponent interventions. However, multiple, continuous interventions were better than single interventions in terms of eliciting and sustaining behaviour change. Data were not available to determine the time, nature and type of booster sessions with feedback needed for a permanent change in compliance.

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“…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.…”

Section: Observação Direta Das Oportunidades De Higienização Das Mãosunclassified

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

Oliveira

Paula

2011

Acta paul. enferm.

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RESUMOPesquisas realizadas demonstram falta de padronização dos métodos de avaliação da aderência dos profissionais de saúde à prática da higienização das mãos. Assim, este estudo de revisão objetivou identificar os diferentes métodos utilizados para avaliação da aderência a essa prática, referendados na literatura por meio de consulta às seguintes bases de dados -Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Analysis Retrieval System Online e Scientific Eletronic Library Online nas quais foram identificados 210 estudos, dentre os quais foram selecionados 34 artigos divulgados entre os anos de 2001 a 2010. O estudo apresenta os diferentes métodos adotados para realizar a avaliação da aderência aos procedimentos de higienização das mãos e aponta seus pontos fortes e fragilidades, a fim de subsidiar uma análise crítica por parte dos profissionais de saúde, com o intuito de favorecer a escolha do método mais adequado a cada instituição e realidade. Descritores: Lavagem de mãos; Monitoramento; Precauções universais; Fidelidade a diretrizes ABSTRACTSurveys conducted show a lack of standardized methods for assessing the adherence of health professionals to the practice of hand hygiene. Therefore, this review aimed to identify the different methods used to assess adherence to this practice found within the literature, referenced by the following query databases -Latin American and Caribbean Health Sciences, Medical Analysis Retrieval System Online Scientific Electronic Library Online. A total of 210 studies were identified, among which 34 were selected articles published between the years 2001 to 2010. The study presents the different methods used to conduct the evaluation of adherence to hand hygiene procedures and highlights their strengths and weaknesses, in order to subsidize the critical analysis on the part of health professionals, to facilitate the choice of the most appropriate method for each institution and reality. Keywords: Handwashing; Monitoring; Universal precautions; Guideline adherence RESUMENInvestigaciones realizadas demuestran falta de patronización de los métodos de evaluación de la adherencia de los profesionales de salud a la práctica de la higiene de las manos. Así, este estudio de revisión tuvo como objetivo identificar los diferentes métodos utilizados para la evaluación de la adherencia a esa práctica, refrendados en la literatura por medio de consulta a las siguientes bases de datos -Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Medical Analysis Retrieval System Online e Scientific Eletronic Library Online en las cuales fueron identificados 210 estudios, de los cuales fueron seleccionados 34 artículos difundidos entre los años de 2001 a 2010. El estudio presenta los diferentes métodos adoptados para realizar la evaluación de la adherencia a los procedimientos de higiene de las manos y señala sus puntos fuertes y fragilidades, a fin de subsidiar un análisis crítico por parte de los profesionales de salud, con la intención de favorecer la elección de...

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Measurement and interpretation of hand hygiene compliance rates: importance of monitoring entire care episodes

Cited by 41 publications

References 23 publications

Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention

Frequency of Patient Contact with Health Care Personnel and Visitors: Implications for Infection Prevention

Features of educational interventions that lead to compliance with hand hygiene in healthcare professionals within a hospital care setting. A BEME systematic review: BEME Guide No. 22

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

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