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Hand washing in pediatric ambulatory settings. An inconsistent practice.
J A Lohr1, D L Ingram, S M Dudley
1Department of Pediatrics, University of Virginia Children's Medical Center, Charlottesville.
American Journal of Diseases of Children (1960)
|October 1, 1991
Summary
Physician hand washing breaks occurred in over half of patient encounters in pediatric outpatient settings. Reminders did not improve physician hand hygiene compliance, highlighting a critical gap in infection control.
Area of Science:
- Infection Control
- Healthcare Quality Improvement
- Medical Education
Background:
- Physician hand hygiene is crucial for preventing healthcare-associated infections.
- Previous studies indicate suboptimal hand washing compliance among healthcare professionals.
Purpose of the Study:
- To assess the rate of hand washing technique breaches by physicians in pediatric ambulatory care.
- To investigate the influence of physician training level on hand washing compliance.
- To evaluate the effectiveness of reminders in improving physician hand hygiene.
Main Methods:
- Observational study in two pediatric ambulatory settings.
- Medical students observed physician hand washing before patient contact.
- Two phases: initial observation and observation after implementing reminders.
Main Results:
- Phase 1: 51.2% (254/496) of encounters had hand washing breaks.
- Phase 2: 51.2% (150/293) of encounters had hand washing breaks.
- No significant difference in break rates across training levels (residents PGY 1-3, faculty).
Conclusions:
- High rates of hand washing technique breaches persist in pediatric outpatient settings.
- Physician training level did not correlate with hand washing compliance.
- Reminders were ineffective in reducing hand washing breaks, indicating a need for alternative interventions.