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- Title
Hand Hygiene Compliance at Critical Points of Care.
- Authors
Chang, Nai-Chung Nelson; Reisinger, Heather Schacht; Schweizer, Marin L; Jones, ichael; Chrischilles, Elizabeth; Chorazy, Margaret; Huskins, Charles; Herwaldt, Loreen
- Abstract
Background Most articles on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers (HCWs) are noncompliant. We assessed how task type affected HCWs' hand hygiene compliance. Methods We linked consecutive tasks individual HCWs performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study into care sequences and identified task pairs—2 consecutive tasks and the intervening hand hygiene opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, HCW type, and compliance at prior opportunities. Results Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR], 0.97 [95% confidence interval {CI},.95–.98]) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR, 1.12 [95% CI, 1.10–1.13]). Nurses were more likely to perform both critical and contaminating tasks, but nurses' hand hygiene compliance was better than physicians' (aOR, 0.94 [95% CI,.91–.97]) and other HCWs' compliance (aOR, 0.87 [95% CI,.87–.94]). Conclusions Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.
- Subjects
PREVENTION of infectious disease transmission; CROSS infection prevention; INTENSIVE care units; PROFESSIONS; CONFIDENCE intervals; PREVENTION of communicable diseases; TASK performance; MEDICAL protocols; LEGAL compliance; GLOVES; HAND washing; ODDS ratio; LOGISTIC regression analysis; ISOLATION (Hospital care); PERSONNEL management
- Publication
Clinical Infectious Diseases, 2021, Vol 72, Issue 5, p814
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa130