Compliance of Healthcare Workers with Hand Hygiene Practices in the Northeast of Iran: an Overt Observation

Hand hygiene (HH) is one of the most effective methods to prevent transmission and spread of microorganisms from one patient to another, also, it used to reduce the spread of pathogens in clinical settings and to help control outbreaks but compliance is usually poor. The purpose of this study was to analyze the compliance of hand hygiene and affecting factors among healthcare workers (HCWs) of northeast hospitals in Iran. This study was conducted based on observation method for the compliance of hand hygiene according to the World Health Organization (WHO) guidelines. HCWs were observed during routine patient care in different shifts, also the technique of hand hygiene was assessed through hand washing with alcohol-based disinfectant. Data were collected during 1 year, from June 2014 to July 2015 by the infection control teams in the northeast hospital of Iran. By direct observation, we evaluated a total of 92518 hand hygiene opportunities from 29 hospitals in the northeast of Iran during 1 year, with overall compliance rates in these hospitals were 43.42%. Compliance rates differed by role: nurses43%, doctors 19 % and other health workers 29%. In this observational study, we identified that adherence to hand hygiene practice and use of alcohol-based disinfectant was very low in this hospitals, so effective intervention programs to promote adherence to hand hygiene and use of disinfectants could be effective to increase compliance

Promoting Good Hygiene Practices: Key Elements and Practical Lessons

Summarizes papers and case studies about promoting hygiene in South and Southeast Asia, the Pacific, and Africa. Synthesizes lessons learned, including: know the focus groups, ensure opportunities for change, and enable and motivate good hygiene practice

An approach to hygiene education among rural Indian school going children

Objectives: To find out the prevalence of intestinal parasites and its epidemiological correlates among rural Indian school going (6-14 years) children and to study the effect of focused, need based child to child hygiene education on personal hygiene of school children. Materials and Methods: In September 2007, the present participatory action research was undertaken at a feasibly selected village Dhotra (Kasar) in Wardha district of central India. A triangulated research design of quantitative (survey) and qualitative (transect walk & pile sorting) methods was used for the needs assessment before initiating formal hygiene education. Out of enlisted 172 children, data of 118 children with complete information was used for final analysis. The quantitative and qualitative data was entered and analyzed using the Epi Info 6.04 software and Anthropac 4.98.1/X software package respectively. School based participatory life skills based child to child hygiene education was undertaken for message dissemination and behavior change. The effect of this hygiene education on identified key behaviors was assessed after one month Results: Out of the 118 (50 male and 68 female) subjects examined 21 (17.8%, 95%CI, 11.4 – 25.9%) had intestinal parasite infection. The prevalence of intestinal parasitic infection was significantly high among children having dirty untrimmed nails (47.4%, 95%CI, 30.9 – 64.1%) followed by those having poor hand washing practices (37.2%, 95%CI, 22.9 – 53.2%). One month after hygiene education, the proportion of children having practice of hand washing with soap after defecation significantly improved from 63.6 % to 78%. The proportion of clean and cut nails also improved from 67.8% to 80 % (p<0.05). Conclusions: The need based, focused, life skills based child to child hygiene education was effective for behavior change. An integrated approach of drug treatment and focused participatory hygiene education is required to control parasite load among rural Indian school going children

Opportunities for faculty-librarian collaboration in an expanded dentistry curriculum.

With the increased emphasis on evidence-based practice, developing information literacy (IL), as well as other literacies (e.g., oral), earlier in programs is becoming widely accepted in medicine and allied fields. However with long-standing programs integration of IL instruction is often unplanned at the programmatic level. This contributes to deficiencies in advanced students and frustrations for students and faculty. The Indiana University School of Dentistry has expanded its Dental Hygiene curriculum from a two-year program to a four-year Bachelor of Science. This expansion provided the opportunity to plan integration of information and oral health literacy instruction and evidence-based practice across the new curriculum. Library and Dental Hygiene faculty collaborated to adapt existing undergraduate and oral health pedagogies and assessments, as well as create new ones which are appropriate for integration into various courses. This expanded curriculum integrates lesson plans, assignments, and assessments that support dental hygiene and other health fields but also complement general education and provide transferrable skills for any major. Courses have heavy librarian integration, both in the classroom and the course management software, as well as asynchronous learning tools, with opportunities for team teaching and robust student assessment, including authentic assessment

Hand hygiene techniques:Still a requirement for evidence for practice?

Introduction Two hand hygiene techniques are promoted internationally: the World Health Organisation’s 6 step and the Centre for Disease Control’s 3 step techniques; both of which may be considered to have suboptimum levels of empirical evidence for use with alcohol based hand rub (ABHR). Objectives The aim of the study was to compare the effectiveness of the two techniques in clinical practice. Methods A prospective parallel group randomised controlled trial (RCT) was conducted with 1:1 allocation of 6 step versus the 3 step ABHR hand hygiene technique in a clinical setting. The primary outcome was residual microbiological load. Secondary outcomes were hand surface coverage and duration. The participants were medical and nursing participants (n=120) in a large teaching hospital. Results The 6 step technique was statistically more effective at reducing the bacterial count 1900cfu/ml (95% CI 1300, 2400cfu/ml) to 380cfu/ml (95% CI 150, 860 cfu/ml) than the 3 step 1200cfu/ml (95% CI 940, 1850cfu/ml) to 750cfu/ml (95% CI 380, 1400cfu/ml) (p=0.016) but even with direct observation by two researchers and use of an instruction card demonstrating the technique, compliance with the 6 step technique was only 65%, compared to 100% compliance with 3 step technique. Further those participants with 100% compliance with 6 step technique had a significantly greater log reduction in bacterial load with no additional time or difference in coverage compared to those with 65% compliance with 6 step technique (p=0.01). Conclusion To our knowledge this is the first published RCT to demonstrate the 6 step technique is superior to the 3 step technique in reducing the residual bacterial load after hand hygiene using alcohol based hand rub in clinical practice. What remains unknown is whether the residual bacterial load after the 3 step technique is low enough to reduce risk of transmission from the hands and whether the 6 step technique can be adapted to enhance compliance in order to maximise reduction in residual bacterial load and reduce duration

Reducing hospital associated infection : a role for social marketing

Purpose: Although hand hygiene is seen as the most important method to prevent the transmission of hospital associated infection in the UK, hand hygiene compliance rates appear to remain poor. This research aims to assess the degree to which social marketing methodology can be adopted by a particular organization to promote hand hygiene compliance. Design/Methodology/Approach: The research design is based on a conceptual framework developed from analysis of social marketing literature. Data collection involved taped interviews given by nursing staff working within a specific Hospital Directorate in Manchester, England. Supplementary data was obtained from archival records of the hand hygiene compliance rates. Findings: Findings highlighted gaps in the Directorate’s approach to the promotion of hand hygiene compared to what could be using social marketing methodology. Respondents highlighted how the Directorate failed to fully optimise resources required to endorse hand hygiene practice and this resulted in poorer compliance. Originality/Value: From the experiences and events documented, the study suggests how the emergent phenomena could be utilized by the Directorate to apply a social marketing approach which could positively influence hand hygiene compliance

Faktor-faktor yang Berhubungan dengan Tingkat Kepatuhan Tenaga Kesehatan Melakukan Cuci Tangan (Studi Kasus di Instalasi Rawat Inap Rajawali Rsup Dr. Kariadi Semarang)

Disobedience of health care workers to practice hand hygiene often related with the incidence of nosocomial infection in hospital. Nosocomial infection rates in Rajawali Inpatient Installation of RSUP Dr. Kariadi Semarang is 24,4 permile and including one of high rates in RSUP Dr. Kariadi areas. Obedience rate of health care workers on October 2014 is 48,2% which is far away from achievement target 100%. This research will aims to analyzing correlation factors with obedience level of health care workers to practice hand hygiene in Rajawali Inpatient Installation of RSUP Dr. Kariadi Semarang. This research is a quantitative research with cross-sectional approach. Respondents of this research is 70 health care workers in Rajawali Inpatient Installation of RSUP Dr. Kariadi Semarang. The sampling technique using simple random sampling. Research result shows 60% of respondents was disobedience to practice hand hygiene according to procedure. Statistic analyze with Chi Square Test showed that variables correlated with obedience level of health care workers to practice hand hygiene are knowledge of respondents (p-value= 0,035) and attitude of respondents (p-value= 0,035). Other factors that not correlated with obedience level of health care workers to practice hand hygiene are age of respondents (p-value= 0,308), education level of respondents (p-value= 0,136), work period of respondents (p-value= 1,000), facilities (p-value= 1,000), hand hygiene socialization (p-value= 0,342), regulation (p-value= 1,000), supervision (p-value= 0,148), peer support (p-value= 0,514) due to have p value &gt; 0,05. Necessary hand hygiene training routinely and regulations that offset the sanctions for disobedience of health care workers to practice hand hygiene according to procedure

Are you serious? From fist bumping to hand hygiene: considering culture, context and complexity in infection prevention intervention research

Infection prevention is an under-resourced research and development topic, with limited evidence for practice in the most basic of measures. A survey of IPS R&D members indicated that what might appear to be simple interactions and interventions in healthcare, such as hand shaking and hand hygiene, should be considered complex interventions taking account of behaviour at the individual and social level as well as contextual factors. Future studies need to be designed utilising comprehensive approaches, for example, the Medical Research Council complex interventions framework, tailored to the country and more local cultural context, if we are to be serious about evidence for infection prevention and control practice

Salmonella Infection After Craniotomy.

Salmonella is an uncommon cause of meningitis, especially after neurosurgery. Here, we present a case of Salmonella meningitis after craniotomy, likely due to physical contact with a snake after surgery, with contiguous spread from the patient's hand to her wound. The purpose of this report is to serve as a reminder that patients undergoing neurosurgery should avoid contact with pets, including snakes and other reptiles, in the postoperative period and practice good hand hygiene