Observance of hand washing procedures performed by the medical personnel before patient contact. Part I

Abstract

Introduction: According to the Centers for Disease Control and Prevention (CDC) as well as the World Health Organi zation (WHO) recommendations, medical staff are obliged to decontaminate the skin of the hands before every single patient contact. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff (nurses and physicians) working in three selected hospitals of the Łódź province. The procedure of hand washing and disinfection performed directly before the patient contact according to the CDC and WHO recommendations were observed. The results was subject to statistical analysis (p < 0.05). Results: During 1544 hours of observation 4101 activities requiring hand washing were recorded. The medical staff obeyed the hand washing procedure before the patient contact only in 5.2% of the situations. There was no activity observed before which hand hygiene was maintained in 100% of cases. Observance of hand hygiene depended significantly on the type of the performed activity, the professional group, and the workload index. A decrease in percentage observance of hand hygiene according to the time of the day was found to be of statistical significance. The mean time of hand washing was 8.5 s for physicians and 6.6 s for nurses. Conclusion: The level of observance of hand washing procedures among the medical staff prior to the patient contact appears to be alarmingly below the expectations.

Observance of hand washing procedures performed by the medical personnel after the patient contact. Part II

“…Further description of the structure of the study groups may be found in the paper by Garus-Pakowska et al [1]. During the observations, 4101 activities were reported as requiring hand hygiene.…”

“…The analysis of the hand hygiene procedures performed after contact with patients or potentially infectious material in relation to the sum of all observed situations requiring such hygiene procedures showed that medical personnel washed their hands in 26.4% of circumstances which in accordance with the recommendations required such action. Although the percentage of compliance with hand hygiene "AFTER" patient contact is still low (26.4%), the difference relative to hand washing "BEFORE" patient contact (5.2%) [1] is statistically significant (p < 0.001 ) ( Table 1). activities requiring it was 7.5 s for the personnel of "increased risk" departments and 8.3 s for the personnel of the remaining departments (Table 9).…”

“…Detailed description of the test method has been included in "Observance of hand washing procedures performed by the medical personnel before the patient contact. Part I" [1]. Compliance with hygiene procedures was defined as washing the hands at any time interval with soap and water or antiseptic formulation, or disinfecting the hands by rubbing hand sanitizer immediately after contact with patients, as recommended by the Centers for Disease Control and Prevention in Atlanta and the World Health Organization: -after patient nursing (bathing, making bed, dressing), -in the case of visible soiling of hands, -after performing invasive procedures, -after wound dressing, -after handling catheters and medical equipment parts directly in contact with the tissue of the patient, -after contact with a patient's secretions and excretions, -after using gloves.…”

“…Part I of this paper (Observance of hand washing procedures performed by the medical personnel before the patient contact. Part I. by Garus-Pakowska et al [1]) explains the social and the hygienic hand washing/disinfection of hands by rubbing. According …”

The use of protective gloves by medical personnel

“…Considering that hands were washed more frequently after contact with patients than before such contact [9,10], it once again becomes evident that hand hygiene, as an element of protection against infection, is regarded by the medical personnel as being more for their own protection than for the safety of the patients. The observed multiple use of disposable gloves evidently confirms that attitude.…”