Healthcare workers have low hand hygiene compliance, study finds

Only 20 per cent of healthcare workers can recall WHO's five moments of hand hygiene guidelines, study finds.

A recent study published by the American Journal of Infection Control has found only 20 per cent of healthcare workers can recall the World Health Organization’s hand washing guidelines.

The study examined compliance of WHO’s ‘My 5 Moments for Hand Hygiene’ approach. The assessment was conducted at a healthcare facility between July and August 2016, using a modified WHO hand hygiene observation form.

Researchers observed 302 hand hygiene opportunities in 104 unique healthcare worker-patient interactions. Researchers also conducted a 26-question survey to assess health care personnel knowledge, opinions, and barriers to hand hygiene.

A subgroup participated in a two-round focused survey to assign priority to WHO’s ‘My 5 Moments for Hand Hygiene’, which defines the key moments when health-care workers should perform hand hygiene.

This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings. This approach recommends health-care workers to clean their hands:

  • Before touching a patient,
  • Before clean/aseptic procedures,
  • After body fluid exposure/risk,
  • After touching a patient, and
  • After touching patient surroundings

The study found hand hygiene was performed at 106 of 302 opportunities (35 per cent). Of the 218 healthcare workers who completed the survey 63 (29 per cent) were familiar with WHO’s ‘5 Moments’ but only 13 (21 per cent) were able to recall all five.

In the focused surveys, 46 per cent (six of 13) ranked “before aseptic procedure” as the most important hand hygiene moment, and 86 per cent (11 of 13) identified “after touching patient surroundings” as the least important.

The act of hand hygiene has been shown to reduce healthcare associated infections. Around 500,000 people contract a healthcare associated infection every day according to estimates from WHO (more than 182 million people every year).

NZ compliance on the increase

Earlier this month the Health Quality & Safety Commission announced it would participate in a global survey to assess infection prevention and control programmes in healthcare facilities as part of World Hand Hygiene Day on 5 May.

The survey, coordinated by the World Health Organization, aims to encourage local assessments of infection prevention, and to understand the progress of current hand hygiene activities around the world.

The Health Quality & Safety Commission will be using this data to inform future improvement initiatives in New Zealand.

“Cleaning of hands is one of the most effective ways to prevent the spread of germs; we learn this message early in our lives. Hand hygiene is as powerful as it is simple, and nowhere more so than in healthcare,” said Dr Sally Roberts, clinical lead for the Commission’s infection prevention and control programme.

The latest Hand Hygiene New Zealand audit report by the Commission for November 2018 – March 2019 shows compliance among many healthcare worker categories continues to climb.

“Awareness of the importance of hand hygiene is higher, and engagement with improving hand hygiene compliance continues to grow,” said Dr Roberts.

Hand hygiene compliance by health care workers in New Zealand public hospitals has improved significantly since the hand hygiene programme was launched. Nationally, the compliance rate is 85 percent, up from 62 percent in 2012.

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