Student Dissertation

Agency : Hand Hygiene Practices; Healthcare Workers; Critical Care Unity; Hospital Associated Infection; Hospital Infection

Objective : 1. To assess the hand hygiene practices among health care workers. 2. To identify reasons of the non-compliance in hand hygiene practices.

Background : Hospital associated infections (HAI) persist as a major problem in most Critical Care Units (CCU). Hand hygiene is a simple and most effective method for prevention of hospital associated infections. Therefore, we assessed hand hygiene practices to find out gaps, and plan remedial measure to reduce HAIs.

Methodology : Study setting: The study was undertaken at a PRIME Hospital in Hyderabad. This hospital is 250 bedded multi-specialty hospitals. Study design: Cross –sectional study Study participants: All staff in selected CCU, engaged in giving care to patients. Staff includes duty medical doctors, nurses, technicians and unit helpers. Sample Size: 70 healthcare workers (HCWs) for observation; and or questionnaire (unit helpers were excluded so as to avoid any biases.) Study tools: Observational tool and Questionnaire based on the WHO Observational Tool and Questionnaire for hand hygiene assessment.

Findings : The study revealed disparity between reported and observed hand hygiene practices among health care workers of total, 68% of respondents reported to use soap and water; and 76% alcohol based hand rub for hand hygiene. Compliance in hand hygiene practices was differed among the different categories of HCWs. The main reasons of non-compliance of hand hygiene practices were inconvenient location of sinks/ basins (42%); lack of awareness of need of hand hygiene (32%) and too busy due to work pressure for hand washing (21%).

Recommendations : Increase visibility & place dispensers in workflow Use quality coach or champions for data collection Visual reminders and involving patients & families. Well designed and planned training & evaluation of the CCU staff.