The 2009 H1N1 Influenza A Pandemic and Hand Hygiene Practices in a Hospital in the South of Brazil

Abstract

Between June and September (winter season) 2009, a total of 548 inpatients were evaluated for 2009 H1N1 influenza A infection. Among 154 patients tested for the presence of the H1N1 virus with real-time polymerase chain reaction assay, 75 (48.7%) had positive results. Adherence to hand hygiene was monitored by direct observation in the intensive care unit between July 2006 and March 2010. Between July 2006 and March 2010, a total of 21438 opportunities for hand hygiene were observed. The overall mean adherence rate was 57.1% (range 46.2-69.7%). The mean rate of adherence to hand hygiene was 76.6% (range, 59.5-96.6%) for nurses, compared with 54.1% (range, 43.7-69.6%) for technicians (P<0.001) and 44.2% (range, 23.0%-70.6%) for physicians (P<0.001). The use of alcohol-based hand rub from wall dispensers showed no significant difference in immediate consumption in the intensive care unit (level change from 0.83 to 0.28; P=0.17) but a significant decreased therafter (P=0.05). The use of hand rub from wall dispensers throughout the entire hospital showed a transient significant increase in consumption (level change from 0.59 to 0.64; P<0.001) and a slope decrease thereafter (P=0.02). The mean rate of adherence to hand hygiene before patient contact was 44.5% (range, 23.0-66.7%) and after patient contact was 74.9% (range, 61.8-87.5%) (P<0.00).