This post is also available in: English Slovenščina (Slovenian)
Hand hygiene among health care workers (HCW) is the most important, the easiest and the cheapest preventative measure against nosocomial infections. Hand disinfection is more effective, faster and less harmful for the skin than all other hand hygiene techniques. This study evaluated compliance with hand hygiene rules in an intensive care unit (ICU) where alcoholic hand disinfection is the standard procedure for hands that are not visibly soiled.
Patients and methods. Opportunities for hand hygiene were defined according to CDC guidelines. HCW in 6 patient rooms was observed during routine care and clinical rounds over 2 months. One month into the study, additional infection-control measures were implemented, encouraging HCW to use alcoholic hand disinfection more consistently. Compliance with hand hygiene guidelines was related to the transmission of methicillin-resistant Staphylococcus aureus (MRSA) between patients in the ICU. 531 opportunities for observing hand hygiene were documented. In 75% of the opportunities, HCW performed a hand hygiene procedure: hand disinfection was used in 97% with a mean duration of 7 seconds, whereas hand washing was used in 3% and required a mean of 11 seconds. Compliance was higher after removing gloves (85%), after direct patient contact (89%) and after contact with a patient’s bodily fluids (100%) than between care of clean and dirty bodily areas (21%) and before manipulating vascular and urinary catheters (25%) (p<0.05). After implementing additional infection-control measures, compliance increased significantly, from 72% to 82% (p<0.05). This correlated with a decrease in the incidence of MRSA transmission from 11% to 2% (p=0.003) in the same period. During the study, compliance did not significantly differ among age groups, gender or profession. The overall compliance with hand hygiene in HCW was good (75%). Hand disinfection was performed in 97% of cases. An increase in compliance with hand hygiene was achieved as a result of additional motivation of HCW to use hand disinfection; this also correlated with a significant decrease in MRSA transmission in the ICU.