Surveillance of hand hygiene practices in hospitals, its evaluation, and audit

Abstract

Background: Healthcare-associated infections (HAIs) continue to pose a significant challenge within most intensive care units. The most straightforward and impactful approach to mitigate these HAIs remains proper hand hygiene. Consequently, evaluating documented hand hygiene routines and conducting direct observations are vital in identifying deficiencies. Thus, this enables the formulation of focused approaches to reduce HAIs. Study objectives: (a) To evaluate the hand hygiene practices among healthcare workers and (b) to analyze the factors contributing to non-compliance. Materials and Methods: The research was conducted at the Mayo Institute of Medical Sciences, Intensive Care Unit, Barabanki, Uttar Pradesh, India. This endeavor adopted an observational approach, involving 50 healthcare workers (HCWs) for direct observation and an additional 50 for the evaluation of documented hand hygiene practices. Data collection relied upon the utilization of questionnaires and observation instruments. Results: The investigation brought to light a contrast between the perspectives of healthcare workers and their actual hand hygiene practices. The collective adherence rate stood at 67.08% (with the observation study encompassing 75 HCWs and 111 instances where hand hygiene should have been carried out, out of which only 76 were performed). Notably, physiotherapists exhibited a notably higher compliance rate at 78%, whereas nurses and residents demonstrated a compliance rate of 68%. In contrast, technicians and unit helpers displayed a lower adherence rate of 60%. Regarding reported hand hygiene compliance among HCWs, the figures exceeded 90% (derived from a questionnaire administered to 50 HCWs, some of whom may or may not have been part of the observation study). Nurses reported an impressive 98% compliance, technicians reported 81%, and other personnel reported rates ranging between 90% and 95%. Conclusion: The researcher undertook two distinct investigations involving direct observation and the other based on reported data. The findings from the observational study indicated a collective hand hygiene compliance rate of 67.08%, whereas the reported study yielded a compliance rate exceeding 90% among HCWs.