Identification of factors associated with hand hygiene adherence as a support for creating curriculum for nurses training – a multivariate analysis

Authors

DOI:

https://doi.org/10.20883/medical.e444

Keywords:

handwashing, glove use, nurses, compliance, barriers, education

Abstract

Aim. Handwashing is the easiest way to prevent infection but is often neglected. The purpose of the study was to identify the barriers limiting the respect for hygiene procedures by nurses.

Material and Methods. The study involved direct quasi-participant observation and a questionnaire of 11 nurses in six wards of three hospitals in Poland.

Results. In total,1,195 observations were conducted in which 3,355 activities requiring hygiene procedures were observed over 8 months. The nurses’ knowledge of proper hand hygiene and infection prevention principles were unsatisfactory, with an average value of correct answers in the knowledge test of 8.7 (Max = 15). The univariate analysis indicated the following barriers in hand hygiene: emergencies, allergies, or too few dispensers. In multivariate analysis, the application of hygiene procedures depended on the level of education (higher education – worse compliance with the rules) and subjective conviction that handwashing/glove use was important.

Conclusion. Educational programmes on hand hygiene should focus on the World Health Organisation indications that glove use is not a substitute for handwashing.

Downloads

Download data is not yet available.

References

Boyce J, Pittet D. Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for hand hygiene in health-care settings. MMWR Morbid. Mortal. Wkly. Rep.. 2002 Oct 25;51(RR-16):1-45.

WHO Guidelines on Hand Hygiene in Health Care. First Global Patient Safety Challenge. Clean Care is Safer Care. WHO Press, Geneva 2009. http://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf. Accessed 2020 May 27.

Handwashing: Clean Hands Save Lives. www.cdc.gov/handwashing/when-how-handwashing.html. Accessed 2020 May 27.

Price L, Melone L, Cutajar E, Blane L, Gozdzielewska L, Young M, McAloney-Kocaman K, Reilly J. Investigating the effect of preparation for and participation in a hand-sanitizing relay on nursing students' ability to recall the WHO 6-step hand hygiene technique. American Journal of Infection Control. 2018 Nov;46(11):1304-1306. https://doi.org/10.1016/j.ajic.2018.04.222

Wałaszek M, Kołpa M, Wolak Z, Różańska A, Wójkowska-Mach J. Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture?. International Journal of Environmental Research and Public Health. 2017 Sep 7;14(9):1026. https://doi.org/10.3390/ijerph14091026

Kingston L, O'Connell N, Dunne C. Hand hygiene-related clinical trials reported since 2010: a systematic review. Journal of Hospital Infection. 2016 Apr;92(4):309-320. https://doi.org/10.1016/j.jhin.2015.11.012

Pittet D. Improving Adherence to Hand Hygiene Practice: A Multidisciplinary Approach. Emerging Infectious Diseases. 2001 Apr;7(2):234-240. https://doi.org/10.3201/eid0702.010217

Gluyas H. Understanding non-compliance with hand hygiene practices. Nursing Standard. 2015 Apr 29;29(35):40-46. https://doi.org/10.7748/ns.29.35.40.e9929

Garus-Pakowska A, Sobala W, Szatko F. Observance of hand washing procedures performed by the medical personnel before patient contact. Part I. International Journal of Occupational Medicine and Environmental Health. 2013 Jan 1;26(1). https://doi.org/10.2478/s13382-013-0092-4

Garus-Pakowska A, Sobala W, Szatko F. Observance of hand washing procedures performed by the medical personnel after the patient contact. Part II. International Journal of Occupational Medicine and Environmental Health. 2013 Jan 1;26(2). https://doi.org/10.2478/s13382-013-0094-2

Garus-Pakowska A, Sobala W, Szatko F. The use of protective gloves by medical personnel. International Journal of Occupational Medicine and Environmental Health. 2013 Jan 1;26(3). https://doi.org/10.2478/s13382-013-0095-1

Pittet D. Compliance with Handwashing in a Teaching Hospital. Annals of Internal Medicine. 1999 Jan 19;130(2):126. https://doi.org/10.7326/0003-4819-130-2-199901190-00006

The R Project for Statistical Computing. https://www.r-project.org. Accessed 2020 March 15.

Wałaszek M, Kołpa M, Wolak Z, Różańska A, Wójkowska-Mach J. Patient as a Partner in Healthcare-Associated Infection Prevention. International Journal of Environmental Research and Public Health. 2018 Mar 29;15(4):624. https://doi.org/10.3390/ijerph15040624

Różańska A, Wójkowska-Mach J, Bulanda M. Work experience and seniority in health care vs. medical students’ knowledge of selected hand hygiene procedures. Medycyna Pracy. 2016 Oct 4;67(5):623-633. https://doi.org/10.13075/mp.5893.00440

Kołpa M, Grochowska A, Gniadek A, Jurkiewicz B. Level of knowledge among medical personnel about infections transferred through direct contact – results of questionnaire survey. Przegląd Epidemiologiczny. 2015;69:503-6.

Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet. 2000 Oct;356(9238):1307-1312. https://doi.org/10.1016/s0140-6736(00)02814-2

Rosenthal VD, Guzman S, Safdar N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. American Journal of Infection Control. 2005 Sep;33(7):392-397. https://doi.org/10.1016/j.ajic.2004.08.009

Grayson ML, Jarvie LJ, Martin R, Johnson PDR, Jodoin ME, McMullan C, Gregory RHC, Bellis K, Cunnington K, Wilson FL, Quin D, Kelly A. Significant reductions in methicillin‐resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture‐change program and subsequent successful statewide roll‐out. Medical Journal of Australia. 2008 Jun;188(11):633-640. https://doi.org/10.5694/j.1326-5377.2008.tb01820.x

Gordin FM, Schultz ME, Huber RA, Gill JA. Reduction in Nosocomial Transmission of Drug-Resistant Bacteria After Introduction of an Alcohol-Based Handrub. Infection Control & Hospital Epidemiology. 2005 Jul;26(7):650-653. https://doi.org/10.1086/502596

Johnson PDR, Martin R, Burrell LJ, Grabsch EA, Kirsa SW, O'Keeffe J, Mayall BC, Edmonds D, Barr W, Bolger C, Naidoo H, Grayson ML. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin‐resistant Staphylococcus aureus (MRSA) infection. Medical Journal of Australia. 2005 Nov;183(10):509-514. https://doi.org/10.5694/j.1326-5377.2005.tb07151.x

Pawlik K, Mączyńska A, Fleischer M, Hryniewicz W, eds. Kontrola środowiska szpitalnego w zapobieganiu zakażeniom wywoływanym przez wieloantybiotykooporne patogeny alarmowe. Warszawa: Narodowy Instytut Leków; 2020.

Literacka E, Żabicka D, Hryniewicz W, Gniadkowski M, eds. Dane Krajowego Ośrodka Referencyjnego ds. Lekowrażliwości Drobnoustrojów (KORLD) dotyczące pałeczek Enterobacterales wytwarzających karbapenemazy NDM, KPC, VIM i OXA-48 na terenie Polski w latach 2006-2018. Warszawa: Narodowy Instytut Leków; 2019.

Munita JM, Arias CA. Mechanisms of Antibiotic Resistance. Microbiology Spectrum. 2016 Apr 1;4(2). https://doi.org/10.1128/microbiolspec.vmbf-0016-2015

Diwan V, Gustafsson C, Rosales Klintz S, Joshi SC, Joshi R, Sharma M, Shah H, Pathak A, Tamhankar AJ, Stålsby Lundborg C. Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India. Kumar S. PLOS ONE. 2016 Oct 6;11(10):e0163347. https://doi.org/10.1371/journal.pone.0163347

Keller J, Wolfensberger A, Clack L, Kuster SP, Dunic M, Eis D, Flammer Y, Keller DI, Sax H. Do wearable alcohol-based handrub dispensers increase hand hygiene compliance? - a mixed-methods study. Antimicrobial Resistance & Infection Control. 2018 Nov 23;7(1). https://doi.org/10.1186/s13756-018-0439-5

Fuller C, Savage J, Besser S, Hayward A, Cookson B, Cooper B, Stone S. “The Dirty Hand in the Latex Glove”: A Study of Hand Hygiene Compliance When Gloves Are Worn. Infection Control & Hospital Epidemiology. 2011 Dec;32(12):1194-1199. https://doi.org/10.1086/662619

Downloads

Published

2020-09-30

How to Cite

1.
Garus-Pakowska A. Identification of factors associated with hand hygiene adherence as a support for creating curriculum for nurses training – a multivariate analysis. JMS [Internet]. 2020 Sep. 30 [cited 2024 Mar. 29];89(3):e444. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/444

Issue

Section

Original Papers
Received 2020-07-14
Accepted 2020-09-18
Published 2020-09-30