Hand hygiene compliance at neonate intensive care unit in a Brazilian hospital

Abstract

Introduction/objectives: Several factors influence compliance to hand hygiene (HH) and different variables can be evaluated to improve quality of care assessment, incentive for performance improvement, outbreak investigation and infrastructure design. Objective: To describe the general compliance to HH associated with variablesof interest in a study of direct observation (DO) in a Neonate Intensive Care Unit (NICU) in a University Public Hospital. Methods: DO was performed by 10 observers. Variables were # beds, # health care workers, professional category, type of opportunity, day of week, time of the day and product used. Statistical analysis used software Stata and SPSS for Windows. Results: A total of 7,324 opportunities for HH were identified during 255 1 hour DO periods from December 2008 to March 2009. Overall compliance rate 50.2%. 69.5% for medical doctor (MD), 60.8% for other professionals (OP), 48.7% for nurses (RN) representing respectively 10.8%, 12% and 70.3% of all opportunities. Highest compliance was before aseptic procedure for MD and OP (100% for both) and after touching patient surroundings for RN (73.1%). Lowest compliance was after patient contact for all categories: 52% (MD), 42.7% (OP) and 36.7% (RN). 55% of HH were performed with soap and water, 23.1% with alcohol-based hand rub (ABHR) and 21.9% with soap and water followed by ABHR. Conclusion: DO study results indicated that the NICU did not follow CDC 2002 guideline recommendation for HH. Compliance may be improved by focusing on the opportunities to perform HH using ABHR products.