Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic.
Arch Intern Med
; 160(7): 1017-21, 2000 Apr 10.
Article
en En
| MEDLINE
| ID: mdl-10761968
ABSTRACT
CONTEXT Under routine hospital conditions handwashing compliance of health care workers including nurses, physicians, and others (eg, physical therapists and radiologic technicians) is unacceptably low. OBJECTIVES:
To investigate the efficacy of an education/ feedback intervention and patient awareness program (cognitive approach) on handwashing compliance of health care workers; and to compare the acceptance of a new and increasingly accessible alcohol-based waterless hand disinfectant (technical approach) with the standard sink/soap combination.DESIGN:
A 6-month, prospective, observational study.SETTING:
One medical intensive care unit (ICU), 1 cardiac surgery ICU, and 1 general medical ward located in a 728-bed, tertiary care, teaching facility.PARTICIPANTS:
Medical caregivers in each of the above settings.INTERVENTIONS:
Implementation of an education/ feedback intervention program (6 in-service sessions per each ICU) and patient awareness program, followed by a new, increasingly accessible, alcohol-based, waterless hand antiseptic agent, initially available at a ratio of 1 dispenser for every 4 patients and subsequently 1 for each patient. MAIN OUTCOMEMEASURE:
Direct observation of hand-washing for 1575 potential opportunities monitored over 120 hours randomized for both time of day and bed locations.RESULTS:
Baseline handwashing compliance before and after defined events was 9% and 22% for health care workers in the medical ICU and 3% and 13% for health care workers in the cardiac surgery ICU, respectively. After the education/feedback intervention program, handwashing compliance changed little (medical ICU, 14% [before] and 25% [after]; cardiac surgery ICU, 6% [before] and 13% [after]). Observations after introduction of the new, increasingly accessible, alcohol-based, waterless hand antiseptic revealed significantly higher handwashing rates (P<.05), and handwashing compliance improved as accessibility was enhanced-before 19% and after 41% with 1 dispenser per 4 beds; and before 23% and after 48% with 1 dispenser for each bed.CONCLUSIONS:
Education/feedback intervention and patient awareness programs failed to improve handwashing compliance. However, introduction of easily accessible dispensers with an alcohol-based waterless handwashing antiseptic led to significantly higher handwashing rates among health care workers.
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Banco de datos:
MEDLINE
Asunto principal:
Desinfección de las Manos
/
Personal de Salud
/
Etanol
/
Hospitales de Enseñanza
/
Antiinfecciosos Locales
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2000
Tipo del documento:
Article