A One-year Observational Study on Hand Hygiene Practices in an Open Intensive Care Unit of a Large Teaching Hospital in India
P Naveen Kumar, Shivakumar, Uttham Sharma
Hand hygiene of health care workers, Health careassociated infections, Infection control nurse, Patient safety, World Health Organization observation form study
Citation Information :
Kumar PN, S, Sharma U. A One-year Observational Study on Hand Hygiene Practices in an Open Intensive Care Unit of a Large Teaching Hospital in India. Int J Res Foundation Hosp Healthc Adm 2018; 6 (1):17-21.
Health care-associated infection (HCAI) is the commonest complication affecting hospitalized patients. The infection sources in a hospital are personnel, hospital\'s inanimate environment, and self-infection. Direct transmission accounts to 70% of infection transfer. Bacteria, fungi, and viruses have been reported as causative agents in HCAIs, and many infections are polymicrobial. Effective safety management in the 21st century involves keeping an eye on human factors and highly reliable organizations can identify and capture potential hazards before they show themselves as accidents. One method of achieving this is by measuring the level of safety through “leading” indicators. An active surveillance to measure the adherence to hygiene of hands of employees is conducted by the infection control nurses randomly in the critical areas in this hospital. Hand Hygiene Moment Observation Form taken from the original World Health Organization (WHO) 5 Moments “Observation Form” is used for observation. The compliance among nurses is greater compared with doctors in the intensive care unit (ICU), 64.44 to 60.74%. During the said period, the number of infections incidence in ICU compared with overall hospital\'s infections was 62.98%. The nurses had 7 opportunities and doctors had 10 opportunities to wash hands during 1-hour period, and the average time spent for washing was 8 seconds by doctors and 14 seconds by nurses.
Vincent, C. Patient safety. 2nd ed. West Sussex: Wiley- Blackwell Publishing Ltd; 2010.
Smyth ET, McIlvenny G, Enstone JE, Emmerson AM, Humphreys H, Fitzpatrick F, Davies E, Newcombe RG, Spencer RC; Hospital Infection Society Prevalence Survey Steering Group. Four country healthcare associated infection prevalence survey 2006: overview of the results. J Hosp Infect 2008 Jul;69(3):230-248.
Jarvis, WR. Bennett & Brachman's hospital infections. 5th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2007.
Institute of Medicine. To err is human: building a safer health care system. Washington (DC): National Academy Press; 1999.
Tuazon CU, Perez A, Kishaba T, Sheagren JN. Staphylococcus aureus among insulin-injecting diabetic patients. JAMA 1975 Mar;231(12):1272.
Kaplowitz LG, Comstock JA, Landwehr DM, Dalton HP, Mayhall CG. Prospective study of microbial colonization of the nose and skin and infection of the vascular access site in hemodialysis patients. J Clin Microbiol 1988 Jul;26(7): 1257-1262.
Aly R, Maibach HI, Shinefield HR. Microbial flora of atopic dermatitis. Arch Dermatol 1977 Jun;113(6):780-782.
Kirmani N, Tuazon CU, Murray HW, Parrish AE, Sheagren JN. Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Arch Intern Med 1978 Nov;138(11): 1657-1659.
Goldblum SE, Ulrich JA, Goldman RS, Reed WP. Nasal and cutaneous flora among hemodialysis patients and personnel: quantitative and qualitative characterization and patterns of staphylococcal carriage. Am J Kidney Dis 1982 Sep;2(2):281-286.
Boelaert JR, Van Landuyt HW, Gordts BZ, De Baere YA, Messer SA, Herwaldt LA. Nasal and cutaneous carriage of Staphylococcus aureus in hemodialysis patients: the effect of nasal mupirocin. Infect Control Hosp Epidemiol 1996 Dec;17(12):809-811.
Zimakoff J, Pedersen FB, Bergen L, Baagø-Nielsen J, Daldorph B, Espersen F, Gahrn Hansen B, Høiby N, Jepsen OB, Joffe P, et al. Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark. J Hosp Infect 1996 Aug;33(4):289-300.
Bibel DJ, Greenbert JH, Cook JL. Staphylococcus aureus and the microbial ecology of atopic dermatitis. Can J Microbiol 1997 Aug;23(8):1062-1068.
Bonten MJ, Hayden MK, Nathan C, Van Voorhis J, Matushek M, Slaughter S, Rice T, Weinstein RA. Epidemiology of colonisation of patients and environment with Vancomycin resistant enterococci. Lancet 1996 Dec;348(9042):1615-1619.
Walter CW, Kundsin RB, Shilkret MA, Day MM. Spread of staphylococci to the environment. Antibiot Annu 1958-1959;6:952-957.
Casewell M, Phillips I. Hands as route of transmission for Klebsiella species. Br Med J 1977 Nov;2(6098):1315-1317.
Marples RR, Towers AG. A laboratory model for the investigation of contact transfer of micro-organisms. J Hyg (Lond) 1979 Apr;82(2):237-248.
Ranes, JL.; Gordon, S.; Arroliga, AC. Hospital-acquired, health care–associated, and ventilator-associated pneumonia. Cleveland (OH): The Cleveland Clinic Foundation; 2000-2011.
Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel RP. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin Infect Dis 1999 Aug;29(2):239-244.
Yule, S. Senior management influence on safety performance in the UK and US energy sectors. Doctoral thesis, University of Aberdeen, Scotland. 2003.
WHO. Clean care is safer care. Geneva: WHO; 2015. [cited 2017 Mar 30]. Available from: http://www.who.int/gpsc/en/.
Rotter, M. Hand washing and hand disinfection (Chapter 87). In: Mayhall CG, editor. Hospital epidemiology and infection control. 2nd ed. Philadelphia (PA): Lippincott Williams & Wilkins; 1999.
Boyce, JM. Scientific basis for handwashing with alcohol and other waterless antiseptic agents. In: Rutala WA, editor. Disinfection, sterilization and antisepsis: principles and practices in healthcare facilities. Washington (DC): Association for Professionals in Infection Control and Epidemiology, Inc; 2001.
National Hand Hygiene Compliance Rate—Australia National Data Period Two, 201.
Bukhari SZ, Hussain WM, Banjar A, Almaimani WH, Karima TM, Fatani MI. Hand hygiene compliance rate among healthcare professionals. Saudi Med J 2011 May;32(5):515-519.
Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, Cardo DM. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007 Mar-Apr;122(2):160-166.
World Health Organization. Report on the burden of endemic HAI world-wide; a systematic review of literature. Geneva: WHO; 2011.
Pollack, A. Rising threat of infections unfazed by antibiotics. New York Times, 2010 Feb 27.
Burns, K.; Foley, M.; Donlon, S. Health Protection Surveillance Centre, Point Prevalence Survey of Hospital Acquired Infections & Antimicrobial Use in European Acute Care Hospitals: May 2012. Republic of Ireland: Critical Care Report; 2013.
O'Boyle CA, Henly SJ, Duckett LJ. Nurses’ motivation to wash their hands: a standardized measurement approach. Appl Nurs Res 2001 Aug;14(3):136-145.
Tenorio AR, Badri SM, Sahgal NB, Hota B, Matushek M, Hayden MK, Trenholme GM, Weinstein RA. Effectiveness of gloves in the prevention of hand carriage of vancomycinresistant Enterococcus species by health care workers after patient care. Clin Infect Dis 2001 Mar;32(5):826-829.
Patterson JE, Vecchio J, Pantelick EL, Farrel P, Mazon D, Zervos MJ, Hierholzer WJ Jr. Association of contaminated gloves with transmission of Acinetobacter in an intensive care unit. Am J Med 1991 Nov;91(5):479-483.