Hand hygiene compliance by the health care staff in a pediatric hospital

Abstract

Background: Hospital acquired infections lead to significant morbidity and mortality in hospitalized patients. Proper implementation of hand hygiene by health care personnel (HCP) prevents nosocomial infections. Objectives: To monitor hand hygiene compliance by the medical and nursing staff in different wards of a children’s hospital. Patients and Methods: Four wards were selected for surveillance. In observation periods of 20 minutes each, a trained Pediatric resident observed four patient beds and hand hygiene behavior of health care professionals, physicians (house staff) and nurses, before and after touching the patients. The contacts were classified as ‘high-risk’ if the person came in contact with body fluids or ‘low-risk’ if there was no such contact. Findings were documented on a predesigned Hand Hygiene Observation Tool. Results: Overall, 510 patient contacts were observed and 1020 hand hygiene opportunities before and after patient contact were recorded. In total, 302 contacts (59.2%) were low risk and 208 (40.7%) were high risk. The HCP used disposable and surgical gloves before 87, (41.82%) high risk and 27, (8.94%), low risk contacts; however, no hand washing or the use of alcohol hand rubs before contact was recorded by the observer stationed by the patients’ bed-side. The observer could not ascertain if the HCP washed their hands before entering the 3-6 bedded rooms. Conclusions: Serious lack of adherence to standard protocols for hand hygiene by the HCP together with inappropriate glove use, calls for an urgent strategic planning to educate, train and motivate the health care personnel in all aspects of hand hygiene practices.