Major articleDiurnal variation in hand hygiene compliance in a tertiary level multidisciplinary intensive care unit
Section snippets
Setting
The study was conducted in a 34-bed multidisciplinary tertiary level ICU of a 650-bed super specialty teaching hospital in India. Critically ill patients from all specialties were admitted to the ICU. The ICU is divided into 4 cubicles: 2 cubicles with 9 patients each and 2 additional cubicles with 8 patients each. The study had approval from the hospital Ethics Committee.
Study design
This was a prospective, observational study, conducted over a period of 6 months. Hand hygiene guideline compliance was
Results
During the 6 months of observation 5639 hand hygiene opportunities were recorded for doctors (including physicians, surgeons, physiotherapists, interns, residents, and fellows), nurses, and other paramedical staff. Of the 5639 events of hand hygiene, only 3383 events were properly performed, for a compliance rate of 59.99%. Among doctors, the overall hand hygiene compliance rate was 66.12% (1388/2099), which was higher than the 60.71% of nursing staff (1725/2841) (1388/2099 vs 1725/2841,
Discussion
Results of this study suggest that there is a significant diurnal variation in compliance of hand hygiene for doctors, nurses, and paramedical staff. In general, significant differences existed in the compliance with hand hygiene guidelines among the 3 groups of health care providers.
Previous studies have reported very low rates of hand hygiene practices in the ICU.2, 3, 8, 11, 12, 13, 14, 15, 16, 17, 18 Average compliance with hand hygiene for this study was higher than in previous reports.2, 3
References (24)
APIC guideline for hand washing and hand antisepsis in health care settings
Am J Infect Control
(1995)- et al.
Use of gloves and handwashing behaviour among health care workers in intensive care units: a multicentre investigation in four hospitals in Denmark and Norway
J Hosp Infect
(1993) - et al.
Effectiveness of a hospital-wide programme to improve compliance with hand hygiene
Lancet
(2000) - et al.
Hand hygiene rates unaffected by installation of dispensers of a rapidly acting hand antiseptic
Am J Infect Control
(2000) - et al.
Dissemination of the CDC's hand hygiene guideline and impact on infection rates
Am J Infect Control
(2007) - et al.
Attitudes toward practice guidelines among intensive care unit personnel: a cross-sectional anonymous survey
Heart Lung
(2007) - et al.
Measurement of compliance with hand hygiene
J Hosp Infect
(2007) - et al.
Behavioral interventions to improve infection control practices
Am J Infect Control
(1998) - et al.
The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals
Am J Epidemiol
(1985) - et al.
Hand washing compliance by health care workers
Arch Intern Med
(2000)
A Point-in-Time Observational Study of hand washing practices of healthcare workers in the intensive care unit of St. Luke's Medical Center
Phil J Microbiol Infect
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 Recomm Rep
Cited by (29)
Quantification of diurnal variation in “glove hygiene” compliance in COVID ICUs: An exploratory study
2023, American Journal of Infection ControlCitation Excerpt :HH compliance (HHC) monitoring is often done in the daytime due to logistic reasons. HHC decreases during evening and night shifts2-4; however, documentation of the same and the extent of variation are scarce. The 5 moments of HH as recommended by WHO include before touching a patient, before aseptic procedures, after body fluid exposure, after touching a patient and after touching patient surroundings.
Improved ictal assessment performance in the epilepsy monitoring unit via standardization
2021, Epilepsy and BehaviorValidity of hand hygiene compliance measurement by observation: A systematic review
2019, American Journal of Infection ControlA multimodal intervention to improve hand hygiene compliance in a tertiary care center
2018, American Journal of Infection ControlCitation Excerpt :We observed that HH compliance dropped significantly among HCWs on the night shift compared to HCWs on the day shift. Similar to our study, Sahay et al.17 and Suzuki et al.18 observed that HH was lower during the night shift. They concluded that this higher frequency of HH neglect at night could be explained by a lack of supervision to monitor HH compliance.
Simulation education as a single intervention does not improve hand hygiene practices: A randomized controlled follow-up study
2016, American Journal of Infection Control
Conflicts of interest: None to report.