Hostname: page-component-6b989bf9dc-llglr Total loading time: 0 Render date: 2024-04-14T21:40:22.730Z Has data issue: false hasContentIssue false
  • English
  • Français

Unit-Specific Rates of Hand Hygiene Opportunities in an Acute-Care Hospital

Published online by Cambridge University Press:  28 December 2016

Angela Han ,
Laurie J. Conway ,
Christine Moore ,
Liz McCreight ,
Kelsey Ragan ,
Jannice So ,
Emily Borgundvaag ,
Mike Larocque ,
Brenda L. Coleman  and
Allison McGeer
...Show all authors
Angela Han
Affiliation:
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Laurie J. Conway*
Affiliation:
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
Christine Moore
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Liz McCreight
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Kelsey Ragan
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Jannice So
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Emily Borgundvaag
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Mike Larocque
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada
Brenda L. Coleman
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Infectious Diseases Epidemiology Research Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
Allison McGeer
Affiliation:
Division of Infection Control, Mount Sinai Hospital, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
*
Address correspondence to Laurie J. Conway, RN, PhD, CIC, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 130–155 College Street, Toronto, ON M5T 1P8, Canada (laurie.conway@utoronto.ca).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To explore the frequency of hand hygiene opportunities (HHOs) in multiple units of an acute-care hospital.

DESIGN

Prospective observational study.

SETTING

The adult intensive care unit (ICU), medical and surgical step-down units, medical and surgical units, and the postpartum mother–baby unit (MBU) of an academic acute-care hospital during May–August 2013, May–July 2014, and June–August 2015.

PARTICIPANTS

Healthcare workers (HCWs).

METHODS

HHOs were recorded using direct observation in 1-hour intervals following Public Health Ontario guidelines. The frequency and distribution of HHOs per patient hour were determined for each unit according to time of day, indication, and profession.

RESULTS

In total, 3,422 HHOs were identified during 586 hours of observation. The mean numbers of HHOs per patient hour in the ICU were similar to those in the medical and surgical step-down units during the day and night, which were higher than the rates observed in medical and surgical units and the MBU. The rate of HHOs during the night significantly decreased compared with day (P<.0001). HHOs before an aseptic procedure comprised 13% of HHOs in the ICU compared with 4%–9% in other units. Nurses contributed >92% of HHOs on medical and surgical units, compared to 67% of HHOs on the MBU.

CONCLUSIONS

Assessment of hand hygiene compliance using product utilization data requires knowledge of the appropriate opportunities for hand hygiene. We have provided a detailed characterization of these estimates across a wide range of inpatient settings as well as an examination of temporal variations in HHOs.

Infect Control Hosp Epidemiol 2017;38:411–416

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 4 , April 2017 , pp. 411 - 416
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR 2002;51(RR-16):1–45; quiz CE41-454.Google Scholar
2. Erasmus, V, Daha, TJ, Brug, H, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010;31:283–294.Google Scholar
3. Mahida, N. Hand hygiene compliance: are we kidding ourselves? J Hosp Infect 2016;92:307–308.Google Scholar
4. Brouqui, P, Aladro, AS. Alcohol hand rub consumption objectives in European hospitals need to be revisited. Clin Microbiol Infect 2016;22:577.CrossRefGoogle ScholarPubMed
5. Boyce, JM. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infect Control Hosp Epidemiol 2011;32:1016–1028.CrossRefGoogle ScholarPubMed
6. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. World Health Organization website. http://apps.who.int/iris/bitstream/10665/44102/1/9789241597906_eng.pdf. Published 2009. Accessed February 29, 2016.Google Scholar
7. Haas, JP, Larson, EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:6–14.CrossRefGoogle ScholarPubMed
8. Eckmanns, T, Bessert, J, Behnke, M, Gastmeier, P, Ruden, H. Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infect Control Hosp Epidemiol 2006;27:931–934.Google Scholar
9. Srigley, JA, Furness, C, Baker, GR, Gardam, M. Quantification of the hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ Qual Safety 2014;23:974–980.Google Scholar
10. Hagel, S, Reischke, J, Kesselmeier, M, et al. Quantifying the Hawthorne effect in hand hygiene compliance through comparing direct observation with automated hand hygiene monitoring. Infect Control Hosp Epidemiol 2015;36:957–962.Google Scholar
11. Azim, S, Juergens, C, Hines, J, McLaws, ML. Introducing automated hand hygiene surveillance to an Australian hospital: mirroring the HOW2 benchmark study. Am J Infect Control 2016;44:772–776.Google Scholar
12. Goodliffe, L, Ragan, K, Larocque, M, et al. Rate of healthcare worker-patient interaction and hand hygiene opportunities in an acute care setting. Infect Control Hosp Epidemiol 2014;35:225–230.Google Scholar
13. Steed, C, Kelly, JW, Blackhurst, D, et al. Hospital hand hygiene opportunities: where and when (HOW2)? The HOW2 Benchmark Study. Am J Infect Control 2011;39:19–26.Google Scholar
14. Larson, EL, Albrecht, S, O’Keefe, M. Hand hygiene behavior in a pediatric emergency department and a pediatric intensive care unit: comparison of use of 2 dispenser systems. Am J Crit Care 2005;14:304–312.Google Scholar
15. Scheithauer, S, Haefner, H, Schwanz, T, et al. Compliance with hand hygiene on surgical, medical, and neurologic intensive care units: direct observation versus calculated disinfectant usage. Am J Infect Control 2009;37:835–841.CrossRefGoogle ScholarPubMed
16. Scheithauer, S, Oude-Aost, J, Heimann, K, et al. Hand hygiene in pediatric and neonatal intensive care unit patients: daily opportunities and indication- and profession-specific analyses of compliance. Am J Infect Control 2011;39:732–737.CrossRefGoogle ScholarPubMed
17. Best practices for hand hygiene in all health care settings, 4th ed. Public Health Ontario website. https://www.publichealthontario.ca/en/eRepository/2010-12%20BP%20Hand%20Hygiene.pdf. Published 2010. Accessed April 22, 2016.Google Scholar
18. Just clean your hands: education, training and tools for hospitals. Public Health Ontario website. https://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-Hospitals-Education-and-training.aspx#.VxvCzPkrKUk. Published 2016. Accessed April 22, 2016.Google Scholar
19. Alper, PM, Allison, , Blackhurst, D, Boeker, S, Moore, C. Four moments for hand hygiene vs 5—what’s the actual difference? Poster presented at the 2015 IPAC Canada National Conference; June 15, 2015, Victoria, BC.Google Scholar
20. Diller, T, Kelly, JW, Blackhurst, D, Steed, C, Boeker, S, McElveen, DC. Estimation of hand hygiene opportunities on an adult medical ward using 24-hour camera surveillance: validation of the HOW2 benchmark study. Am J Infect Control 2014;42:602–607.Google Scholar
21. Eliassen, KM, Hopstock, LA. Sleep promotion in the intensive care unit—a survey of nurses’ interventions. Intensive Crit Care Nurs 2011;27:138–142.CrossRefGoogle ScholarPubMed
22. Radtke, K, Obermann, K, Teymer, L. Nursing knowledge of physiological and psychological outcomes related to patient sleep deprivation in the acute care setting. Med Surg Nurs 2014;23:178–184.Google Scholar
Supplementary material: PDF

Han supplementary material

Han supplementary material 1

Download Han supplementary material(PDF)
PDF 454.5 KB
Supplementary material: File

Han supplementary material

Han supplementary material 2

Download Han supplementary material(File)
File 45 KB