Use of hand hygiene agents as a surrogate marker of compliance in Hungarian long-term care facilities: first nationwide survey

Abstract

BackgroundHand hygiene practice is an important measure for preventing infections in long-term care facilities (LTCFs). However, low compliance with hand hygiene has been reported in a number of studies. The purpose of this study was to provide an overview of the first reference data collected on alcohol-based handrub (ABHR) and antiseptic soap consumption, as surrogate markers for hand hygiene compliance by healthcare workers (HCWs) in Hungarian LTCFs. The objective was to inform stakeholders on the need of hand hygiene improvement in these settings.MethodsBetween 5 May and 30 September 2014, we conducted a nationwide, cross-sectional survey using a standardized self-administered questionnaire; all Hungarian LTCFs were eligible. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis.ResultsThe questionnaire was completed by 354 LTCFs, representing 24 % of all Hungarian LTCFs. In total, the median consumption of ABHR and antimicrobial soap was 15.5 L (IQR, 0–800 L) and 60 L (IQR, 0–1,680 L) per LTCFs, and 2.2 mL (IQR, 0.4–9.1 mL) and 12.1 mL (IQR, 0.7–32.8 mL) per HCWs in 2013, respectively. The estimated number of hand hygiene actions was 0.6 hygienic handrub/HCW per day (IQR, 0–12.8/HCWs) and 2.4 hygienic handwashing/HCW per day (IQR, 0–21.9/HCWs; P = .001), respectively.ConclusionsThis study suggests that non-compliance with hand hygiene is a significant problem in Hungarian LTCFs. Based on our results, there is an urgent need for a nationwide multimodal hand hygiene promotion strategy including education and performance monitoring and feedback in all LTCFs. Furthermore, monitoring of ABHR consumption constitute an additional component of the existing National Nosocomial Surveillance system.

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

“…ABHR consumption monitoring has been officially recommended in "The surveillance procedures for small and medium sized medical facilities" since 2009 in Japan and has also been applied by the European Centre for Disease Prevention and Control [34] for standardized surveillance purposes. Many reports from Europe [35][36][37][38] and a report from Africa [39] have indicated the adoption of indirect monitoring of HH activity based on an ABHR consumption system. As long as direct observations are also conducted for qualitative measures and no punitive approaches are taken, ABHR consumption monitoring may be considered as a practical measure, especially for assessing improvement in long-term initiatives, for facilities with limited resources.…”

Identifying interventions to improve hand hygiene compliance in the intensive care unit through co-design with stakeholders

“…This suggests that positive role models can also have the same effect. This positive motivation could be achieved by encouraging senior staff members, particularly consultants and senior nursing staff, to act as role models for junior staff members 23 . However, it is important that in such interventions the role of different levels of leadership (e.g., senior clinical staff, management) and styles of leadership are clear if the intervention is to be effective 24 .…”

The importance of infection prevention and control in chronic wound care

“…A fertőzéseket kiváltó mikroorganizmusok terjedése leggyakrabban a dolgozók kontaminált kezei által, direkt és indirekt kontaktussal történik mind az aktív fekvőbeteg-ellátó, mind a bentlakásos szociális intézmények esetében (13)(14)(15). Ezen patogének által okozott fertőzések megelőzésének legegyszerűbb, leghatékonyabb és legolcsóbb módszere a kézhigiéné (azaz, fertőtlenítő kézmosás egyfázisú tisztító/fertőtlenítő hatású szerrel és/vagy kézfertőtlenítés alkohol alapú fertőtlenítő szerrel), melynek hatékonyságát Semmelweis Ignác már 1847-ben bebizonyította, napjainkban pedig már számos vizsgálat eredménye támasztja alá a kezek szerepét (14)(15)(16).…”