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Differences in Hand Hygiene Behavior Related to the Contamination Risk of Healthcare Activities in Different Groups of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Constanze Wendt*
Affiliation:
Hygiene-Institut der Universität Heidelberg, Heidelberg, Germany
Donald Knautz
Affiliation:
Institut für Hygiene und Infektionsschutz, Landau, Germany
Heike von Baum
Affiliation:
Sektion Klinikhygiene, Universitätsklinikum Ulm, Ulm, Germany
*
Hygiene Institut, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany

Abstract

Background:

The Fulkerson scale lists 15 typical clinical activities ranked according to their risk of hand contamination.

Objective:

To investigate how often healthcare workers (HCWs) apply antiseptic handrubs after each of the specified activities ranked in the Fulkerson scale.

Design:

Observational study.

Setting:

University Hospital of Heidelberg, a 1,600-bed teaching hospital.

Methods:

Using a structured protocol, 41 observers recorded whether HCWs rubbed their hands in 1 of 15 given situations.

Results:

Handrubs were used in 1,115 (52.2%) of 2,138 observations. Comparatively high rates of handrub use were observed after contact with sterile materials (39.6%) and after contact with excretions (90% to 97%). Nurses used handrubs significantly more frequently than did physicians after contact with the inanimate environment, but physicians applied handrubs significantly more frequently after contact with body secretions.

Conclusions:

This study showed better compliance with hand hygiene than that reported by many previous studies, but compliance was still inadequate and varied significantly by type of HCW, type of activity, and location in the hospital.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Semmelweis, IP. Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers. Pest, Hungary: C. A. Hartleben; 1861.Google Scholar
2.Boyce, JM. Antiseptic technology: access, affordability, and acceptance. Emerg Infect Dis 2001;7:231233.Google Scholar
3.Earl, ML, Jackson, MM, Rickman, LS. Improved rates of compliance with hand antisepsis guidelines: a three-phase observational study. Am JNurs 2001;101:2633.Google ScholarPubMed
4.Feather, A, Stone, SP, Wessier, A, Boursicot, KA, Pratt, C. ‘Now please wash your hands’: the handwashing behaviour of final MBBS candidates. J Hosp Infect 2000;45:6264.Google Scholar
5.Harris, AD, Samore, MH, Nafziger, R, DiRosario, K, Roghmann, MC, Carmeli, Y. A survey on handwashing practices and opinions of healthcare workers. J Hosp Infect 2000;45:318321.Google Scholar
6.Maley, MP. Compliance with hand washing. Infect Control Hosp Epidemiol 2000;21:4.Google Scholar
7.McGuckin, M, Waterman, R, Storr, J, et al. Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect 2001;48:222227.Google Scholar
8.Naikoba, S, Hayward, A. The effectiveness of interventions aimed at increasing handwashing in healthcare workers: a systematic review. J Hosp Infect 2001;47:173180.Google Scholar
9.Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene: infection control programme. Lancet 2000;356:13071312.Google Scholar
10.Larson, EL, Early, E, Cloonan, P, Sugrie, S, Parides, . An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:1422.Google Scholar
11.Watanakunakorn, C, Wang, C, Hazy, J. An observational study of hand washing and infection control practices by healthcare workers. Infect Control Hosp Epidemiol 1998;19:858860.Google Scholar
12.Thompson, BL, Dwyer, DM, Ussery, XT, et al. Handwashing and glove use in a long-term–care facility. Infect Control Hosp Epidemiol 1997;18:97103.Google Scholar
13.Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002;23(suppl):SlS40.Google Scholar
14.Wendt, C. Hand hygiene: comparison of international recommendations. J Hosp Infect 2001;48(suppl A):S23S28.Google Scholar
15.Rotter, ML. Hand washing and hand disinfection. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996:10521068.Google Scholar
16.Anonymous. Handewaschen und hándedesinfektion. Bundesgesundheitsbl 1985;28:185.Google Scholar
17.Kramer, A, Christiansen, B, Exner, M, Rotter, M. Händehygiene: Mitteilung der Kommission für Krankenhaushygiene und Infektionsprävention am Robert Koch-Institut. Bundesgesundheitsbl 2000;43:230233.Google Scholar
18.Pittet, D, Mourouga, P, Perneger, TV, Members of the Infection Control Program. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126130.CrossRefGoogle ScholarPubMed
19.Sproat, LJ, Ingiis, TJJ. A multicentre survey of hand hygiene practice in intensive care units. J Hosp Infect 1994;26:137148.Google Scholar
20.Kretzer, EK, Larson, EL. Behavioral interventions to improve infection control practices. Am J Infect Control 1998;26:245253.Google Scholar