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Published on: June 7, 2017
Evolution and associated factors of hand hygiene compliance in a pediatric tertiary hospital
P Gras-Valentí1, J G Mora-Muriel2, M Fuster-Pérez1
1Preventive Medicine Service, Alicante University General Hospital, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Planta 5. Centro de Diagnóstico. Hospital General Universitario de Alicante, Alicante, Spain.
Insights
Hand hygiene compliance in pediatric care areas (PCAs) was 64.3%, higher than other hospital areas. Focusing on modifiable factors like alcohol-based hand rub availability can improve compliance and reduce infections.
Area of Science:
- Healthcare epidemiology
- Infection prevention and control
- Clinical microbiology
Background:
- Hand hygiene (HH) is crucial for preventing healthcare-associated infections (HAIs).
- Assessing the Degree of Compliance with Recommendations (DCR) for HH is essential for effective infection control.
- Pediatric care areas (PCAs) present unique challenges for maintaining high HH standards.
Purpose of the Study:
- To evaluate the evolution of HH compliance in PCAs over 13 years.
- To identify factors associated with HH compliance specifically within PCAs.
- To inform strategies for improving HH practices and reducing HAIs in pediatric settings.
Main Methods:
- An observational, cross-sectional study with repeated measurements over 13 years.
- Direct observation of 9226 HH opportunities among healthcare workers in PCAs.
- Statistical analysis using chi-squared tests and adjusted odds ratios (aOR) to identify associated factors.
Main Results:
- The overall DCR for HH in PCAs was 64.3%, significantly higher than in non-pediatric areas (49.6%).
- Highest compliance rates were observed in Oncology (72.8%), Neonatology (73.2%), and Neonatal Intensive Care Units (70.0%).
- Factors independently associated with higher HH compliance included specific care areas, performing HH after an activity, and availability of pocket-size alcohol-based solutions.
Conclusions:
- HH compliance in PCAs exceeds that in other areas but still has room for improvement.
- Modifiable factors, such as the availability of alcohol-based hand rubs, are strongly associated with HH compliance.
- Targeting these modifiable factors offers a promising strategy to enhance HH compliance and decrease HAIs in pediatric populations.
Background:
The objective is to know the evolution of the Degree of Compliance with Recommendations (DCR) on hand hygiene (HH) and its associated factors in the pediatric care areas (PCAs) of a tertiary hospital.
Methods:
Observational, cross-sectional study, repeated over time, with direct observation of the DCR on HH during the daily activity of health care workers. Over 13 years, 9226 HH opportunities were observed. Associations between DCR, PCA and other variables (eg, age, sex, and professional position) were examined using χ² and adjusted odds ratios (aOR) with 95% confidence intervals (CI).
Results:
DCR on HH in 9 PCAs was 64.3% (95% CI, 63.3-65.3), and in the group of non-pediatric areas it was 49.6% (95% CI, 49.1-50.1). The areas with the highest degree of compliance were Oncology 72.8% (95% CI, 69.2-76.4), Neonatology 73.2% (95% CI, 71.3-75.1), and Neonatal intensive care unit 70.0% (95% CI, 67.5-72.6). These were the areas with the strongest association with HH compliance, with aOR:2.8 (95% CI, 2.2-3.6); aOR, 3.0 (95% CI, 2.6-3.6) aOR:2.6 (95% CI, 2.1-3.1), respectively. Other associated factors were the indications "after an activity," aOR, 1.6 (95% CI, 1.5-1.8) and the availability of pocket-size alcohol-based solution, aOR, 2.1(95% CI, 1.9-2.3).
Conclusions:
The DCR on HH in PCAs is higher than in other areas, although there is still margin for improvement. We have identified modifiable factors that have an independent association with HH compliance in PCAs. Focusing on modifiable factors will increase compliance with HH with the ultimate goal of reducing healthcare associated infections.
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