Compliance and Performance of Hand Hygiene in Dutch General Practice Offices Using Electronic Dispensers

Area of Science:

• Healthcare-associated Infections (HAI)
• Infection Prevention and Control
• General Practice Management

Background:

• Hand hygiene (HH) is crucial for reducing healthcare-associated infections (HAI).
• Direct observation of HH in general practice offices (GPOs) is challenging.
• Electronic monitoring is a recognized method for assessing product use and compliance.

Purpose of the Study:

• To evaluate hand hygiene compliance in Dutch general practice offices.
• To assess the feasibility of electronic monitoring for HH in this setting.

Main Methods:

• An observational study was conducted in 4 Dutch GPOs from 2019-2021.
• Alcohol-based hand rub (ABHR) dispensers with electronic counters monitored HH events (HHE).
• HH opportunities were calculated based on the 'Five Moments for Hand Hygiene' and electronic patient records.

Main Results:

• Overall HH compliance was 41% (1786/4322 opportunities).
• Compliance varied: General Practitioners (GPs) 38%, Practice Assistants 51%, Nurse Practitioners 43%.
• HH compliance increased from 42% pre-pandemic to 56% during the pandemic.

Conclusions:

• HH compliance in Dutch GPOs is suboptimal at 41%, with GPs showing the lowest adherence.
• Electronic monitoring provides valuable data on HH performance and ABHR usage.
• Multi-modal interventions are necessary to enhance HH compliance in Dutch general practices.