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A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
An observational study of hand hygiene compliance in paediatric wards
Jacqueline Randle1, Joseph Firth, Natalie Vaughan
1School of Nursing, Midwifery and Physiotherapy, University of Nottingham, University Park, Nottingham, UK. jacqueline.randle@nottingham.ac.uk
Insights
Healthcare workers showed 74% hand hygiene compliance, exceeding previous estimates. Visitor and child compliance was significantly lower, highlighting a need for targeted interventions in paediatric wards to reduce healthcare-associated infections.
Area of Science:
- Infection Prevention and Control
- Paediatric Healthcare
- Public Health
Background:
- Children in clinical settings are highly susceptible to healthcare-associated infections (HAIs).
- Limited research exists on hand hygiene compliance within paediatric healthcare environments.
- Understanding compliance is crucial for developing effective infection control strategies.
Purpose of the Study:
- To quantify hand hygiene compliance among healthcare workers, children, and visitors.
- To compare compliance rates across different roles and clinical settings (paediatric oncology and respiratory wards).
- To identify specific moments of hand hygiene with lower compliance for targeted interventions.
Main Methods:
- An observational study was conducted in two English hospital wards.
- The 'five moments of hand hygiene' tool was used to monitor compliance over an eight-hour period.
- A total of 407 hand hygiene opportunities were observed.
Main Results:
- Healthcare workers achieved 74% hand hygiene compliance, with allied health professionals (84%), doctors (81%), and nurses (75%) showing higher rates than ancillary staff (73%).
- Compliance varied significantly by the 'five moments' (e.g., 90% before child contact vs. 36% after surroundings contact).
- Visitor and child compliance was notably low at 23%, although oncology ward visitors showed higher compliance than others.
Conclusions:
- While children's compliance could not be definitively assessed, visitor compliance was low, despite their significant role in care delivery.
- Healthcare worker hand hygiene compliance exceeded previously reported figures.
- Findings suggest a need for tailored interventions focusing on families and visitors to improve overall hand hygiene in paediatric settings.
Aims And Objectives:
To measure healthcare workers', children's and visitors' hand hygiene compliance in a paediatric oncology ward and a paediatric respiratory ward in an English hospital.
Background:
Children are especially vulnerable to healthcare-associated infections, yet few studies have reported on hand hygiene compliance in paediatric clinical areas.
Design:
This was an observational study.
Method:
We measured hand hygiene compliance over an eight-hour period in two hospital wards using the 'five moments of hand hygiene' observation tool. We monitored a total of 407 hand hygiene opportunities.
Results:
Overall opportunities for compliance were 74% for healthcare workers (n = 315) and children and visitors 23% (n = 92). Compliance was 84% for allied health professionals, 81% for doctors, 75% for nurses and 73% for ancillary and other staff. Hand hygiene compliance varied depending on which of the five moments of hygiene healthcare workers were undertaking (p < 0·001), with compliance before child contact 90% (140/155); after child contact 78% (89/114); after body fluid exposure 75% (3/4); and after surroundings contact 36% (15/42). For healthcare workers and visitors, there was no evidence of an association between time of day and their hand hygiene compliance, and for visitors to the oncology ward, hand hygiene compliance was higher (p < 0·05).
Conclusion:
Owing to the nature of the clinical environments, we are unable to draw conclusions about children's hand hygiene compliance; however, visitors' compliance was low. Among healthcare workers, levels of compliance were higher compared with previous reported estimates.
Relevance To Clinical Practice:
Visitors had the lowest level of compliance yet owing to the nature of the clinical environments, nearly a quarter of care is delivered by them rather than healthcare workers, and so, this offers opportunities for specific future interventions aimed at families and carers.
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