Hand Hygiene (hand + hygiene)

Distribution by Scientific Domains


Selected Abstracts


Impact of Wearable Alcohol Gel Dispensers on Hand Hygiene in an Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 4 2008
Janet P. Haas RN
Abstract Objectives:, Compliance with hand hygiene (HH) by health care workers is widely recognized as the most effective way to decrease transmission of infection among patients. However, compliance remains poor, averaging about 40%. A potential barrier to compliance is convenience and accessibility of sinks or alcohol hand sanitizer dispensers. The purpose of this study was to assess the use of a personal alcohol gel dispensing system, compared with the traditional wall-mounted alcohol gel dispenser and sinks in an urban hospital's emergency department (ED). Methods:, This was a quasi-experimental trial of a personal wearable alcohol hand sanitizer dispenser. Observations of ED staff HH were performed in the month before intervention and during three intervention phases over a 2.5-month period. Results:, A total of 757 HH opportunities were observed: 112 before and 432 after patient contact, 72 after contact with the patient's environment, 24 before invasive procedures, and 117 after body fluid contact. HH compliance improved during the first intervention period, but improvement was not sustained. There was no significant improvement in HH from baseline to the final intervention period. The wearable alcohol gel dispenser was used for 9% of HH episodes. Conclusions:, Availability of a wearable dispenser was not associated with a significant improvement in use of alcohol products for HH. These results support other studies in which only transient success was reported with a single intervention; greater success in sustaining increased HH compliance has been reported with use of multimodal approaches in which increased availability of products may be a part of the intervention. [source]


Hand hygiene among nurses in Turkey: opinions and practices

JOURNAL OF CLINICAL NURSING, Issue 3 2007
Asiye D. Akyol RN
Aims and objectives., This study aims to identify nurses' practices and opinions of handwashing during routine patient care. Background., Transmission of microorganisms from the hands of healthcare workers is the main source of cross-infection in hospitals and can be prevented by handwashing. Design and methods., A questionnaire survey was used for this study. A total of 129 clinical nurses at University of Ege Faculty of Medicine Application and Investigation Hospital at Internal Medicine Clinics was surveyed with a response rate of 100%. Data analysis was carried out using SPSS version 10. Results., The study revealed that nurses have a poor level of knowledge concerning quality of hand washing. All nursing actions related to ,clean' and ,dirty' activities were evaluated using the Fulkerson scale. The majority of nurses reported that they always wash hands after contact with contaminated and non-contaminated patients, equipment and environment. It was found that they did need to wash their hands often but that they were not able to do this because of dense working conditions, insufficiency of necessary materials and drying and sore of hands after frequent washing. Conclusion., To improve hand hygiene and quality of handwashing compliance, additional factors must be considered. These factors include improving healthcare workers , especially nurses', skin conditions, hand hygiene techniques and disinfections substantially. Relevance to clinical practice., Hospitals need to develop and implement innovative educational and motivational programmes tailored to specific groups of health personnel. [source]


The Creation of Emergency Health Care Standards for Catastrophic Events

ACADEMIC EMERGENCY MEDICINE, Issue 11 2006
Robert A. Wise MD
The creation of health care standards by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in a defined area with known events follows a predictable process. A problem area (e.g., hand hygiene) is identified from multiple sources. The JCAHO then calls together experts from around the country, and through debate and the comparison of positions of various people within the health care arena, a new standard informed by these views can be developed. Once developed, it is vetted and becomes established as a Joint Commission standard. But what happens when an event has never happened, cannot be reliably predicted, and, one hopes, will never come to pass? How can one create any meaningful standards? This is the situation when considering a number of scenarios related to disasters and mass casualty events. [source]


A systematic review on the effectiveness of alcohol-based solutions for hand hygiene

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2004
Wilawan Picheansathian RN MS MPH
The use of alcohol has been proposed as an option for hand hygiene. A systematic review was conducted to evaluate the clinical evidence supporting the use of alcohol-based solutions in hospitals as an option for hand hygiene. Studies published between January 1992 and April 2002 in English and Thai, related to the effectiveness of alcohol-based solutions, were reviewed. The databases searched included Medline, DARE, CINAHL and Dissertation Abstracts International. All studies were assessed as having adequate methodological quality. Results of this systematic review supported that alcohol-based hand rubbing removes microorganisms effectively, requires less time and irritates hands less often than does handwashing with soap or other antiseptic agents and water. Furthermore, the availability of bedside alcohol-based solutions increases compliance with hand hygiene among health care workers. [source]


A review of hand-washing techniques in primary care and community settings

JOURNAL OF CLINICAL NURSING, Issue 6 2009
Sheree MS Smith
Aim., This review seeks to identify the most effective hand-washing and hand-cleansing practice that could be used in primary care. Background., Healthcare associated infection is a major problem in the UK causing 5000 deaths every year. Current guidelines indicate expert opinion is the level of evidence for hand washing as an activity to reduce infection. Design., Systematic review. Method., Publications on hand-washing, hand-cleansing studies, policy and practice-based documents were sought by searching several databases. Terms used included hand washing, hand cleansing, hand hygiene, hand decontamination, infection control and primary care. Results., Few articles described the hand-washing technique in detail and some publications simply referred to either the European and British Standards or the Centre for Disease Control statement on hand washing. Major discrepancies in hand position and water flow direction were found. Several methodological problems were also identified and few studies were undertaken in primary care. Conclusion., This review has found a lack of evidence for hand-washing techniques being undertaken in practice today. Findings from hand-washing technique studies were inconclusive and methodological issues exist resulting in sparse reliable evidence. There is an urgent need to undertake methodologically sound studies of hand-washing techniques for use in the ever expanding scope of primary care practice. Relevance to clinical practice., Evidence for hand-washing and hand-cleansing techniques will inform healthcare professional practice, and contribute to the overall management of infection control in primary care. [source]


Hand hygiene among nurses in Turkey: opinions and practices

JOURNAL OF CLINICAL NURSING, Issue 3 2007
Asiye D. Akyol RN
Aims and objectives., This study aims to identify nurses' practices and opinions of handwashing during routine patient care. Background., Transmission of microorganisms from the hands of healthcare workers is the main source of cross-infection in hospitals and can be prevented by handwashing. Design and methods., A questionnaire survey was used for this study. A total of 129 clinical nurses at University of Ege Faculty of Medicine Application and Investigation Hospital at Internal Medicine Clinics was surveyed with a response rate of 100%. Data analysis was carried out using SPSS version 10. Results., The study revealed that nurses have a poor level of knowledge concerning quality of hand washing. All nursing actions related to ,clean' and ,dirty' activities were evaluated using the Fulkerson scale. The majority of nurses reported that they always wash hands after contact with contaminated and non-contaminated patients, equipment and environment. It was found that they did need to wash their hands often but that they were not able to do this because of dense working conditions, insufficiency of necessary materials and drying and sore of hands after frequent washing. Conclusion., To improve hand hygiene and quality of handwashing compliance, additional factors must be considered. These factors include improving healthcare workers , especially nurses', skin conditions, hand hygiene techniques and disinfections substantially. Relevance to clinical practice., Hospitals need to develop and implement innovative educational and motivational programmes tailored to specific groups of health personnel. [source]


Improving hand hygiene in community healthcare settings: the impact of research and clinical collaboration

JOURNAL OF CLINICAL NURSING, Issue 1 2000
Dinah Gould BSc, MPhil
,,Observation of nursing activities and bacteriological studies undertaken with a sample of nurses employed in a community NHS trust indicated that considerable scope for cross infection existed during domiciliary visits. ,,Poor conditions in patients' homes compromised nurses' ability to perform hand hygiene effectively, increasing risks. ,,A clinical trial indicated that carriage of medically significant bacteria likely to contribute to cross infection could be reduced by applying an antiseptic cream which exhibited residual effectiveness. ,,An audit of hand hygiene throughout the inner city trust indicated the need to pay greater attention to hand hygiene, especially during home nursing visits. The situation was less acute in a rural trust where a second audit was performed for comparative purposes. ,,The motivation of clinical staff to improve hand hygiene precautions was high. [source]


Risk of Norovirus Transmission during Air Travel

JOURNAL OF TRAVEL MEDICINE, Issue 5 2009
Krista Kornylo MPH
Background. During October 2006, an outbreak of norovirus gastroenteritis sickened 200 (59%) of the 379 passengers and 26 (18%) of the 144 crew members on a riverboat. In November 2006, CDC was notified that a group of ill passengers had boarded a commercial flight from St Louis, Missouri, to Atlanta, Georgia. A recent study demonstrated probable norovirus transmission from eight symptomatic flight attendants to passengers on board an aircraft during an international flight; however, there are no published reports of transmission of norovirus on flights of short duration. Methods. We investigated the risk of norovirus transmission on a short flight as part of an outbreak response. Using a standardized questionnaire, we conducted interviews of passengers and flight attendants who were on the flight. We collected information on traveler demographics and illness before, during, and after the flight. We also collected information about potential onboard risk factors for norovirus transmission, such as proximity and contact with ill appearing persons during the flight, as well as use of onboard lavatories and hand hygiene. Results. We were able to complete questionnaires for 50 (56%) of the 89 passengers on the flight and 2 (67%) of the 3 flight attendants. Two (5%) of 42 possible secondary cases were identified. These two passengers neither sat in proximity to an index-case passenger during the flight nor reported use of an onboard lavatory. Conclusions. Although onboard transmission cannot be excluded, likelihood of norovirus transmission on a short flight when ill travelers do not have episodes of vomiting or diarrhea appears minimal. [source]


Methicillin-resistant Staphylococcus aureus and beyond: what's new in the world of the ,golden staph'?

ANZ JOURNAL OF SURGERY, Issue 6 2004
Caroline Marshall
Methicillin-resistant Staphylococcus aureus (MRSA) continues to plague our hospitals. With the appearance of isolates that are resistant to vancomycin, now, more than ever, we must direct our efforts to controlling its development and spread. New antimicrobials have become available for treatment, but may only be a short-term answer. Our efforts towards control must be directed towards infection control measures such as improved hand hygiene with user-friendly products, such as alcohol-based hand disinfectants. Intranasal mupirocin may have a place in prevention of surgical site infection, although this role has not yet been clearly defined. Other areas where MRSA control may be effected include prudent controlled use of antibiotics, including surgical prophylaxis. [source]


Impact of Wearable Alcohol Gel Dispensers on Hand Hygiene in an Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 4 2008
Janet P. Haas RN
Abstract Objectives:, Compliance with hand hygiene (HH) by health care workers is widely recognized as the most effective way to decrease transmission of infection among patients. However, compliance remains poor, averaging about 40%. A potential barrier to compliance is convenience and accessibility of sinks or alcohol hand sanitizer dispensers. The purpose of this study was to assess the use of a personal alcohol gel dispensing system, compared with the traditional wall-mounted alcohol gel dispenser and sinks in an urban hospital's emergency department (ED). Methods:, This was a quasi-experimental trial of a personal wearable alcohol hand sanitizer dispenser. Observations of ED staff HH were performed in the month before intervention and during three intervention phases over a 2.5-month period. Results:, A total of 757 HH opportunities were observed: 112 before and 432 after patient contact, 72 after contact with the patient's environment, 24 before invasive procedures, and 117 after body fluid contact. HH compliance improved during the first intervention period, but improvement was not sustained. There was no significant improvement in HH from baseline to the final intervention period. The wearable alcohol gel dispenser was used for 9% of HH episodes. Conclusions:, Availability of a wearable dispenser was not associated with a significant improvement in use of alcohol products for HH. These results support other studies in which only transient success was reported with a single intervention; greater success in sustaining increased HH compliance has been reported with use of multimodal approaches in which increased availability of products may be a part of the intervention. [source]