Objective
To know the present situation of hand hygiene compliance in medical staff and analyze problems in the management of hand hygiene and related influencing factors, in order to take effective control measures and gradually improve hand hygiene compliance in medical staff.
Methods
Between January and October 2014 and between January and October 2015, 8-10 healthcare workers respectively from Department of Internal Medicine, Department of Surgery and Department of Rehabilitation were selected to be observed. The healthcare workers between January and October 2014 before the application of plan-do-check-action (PDCA) cycle were regarded as the control group, and hand hygiene observation was performed in October 2014; the healthcare workers between January and October 2015 were regarded as the observation group (after PDCA application), and hand hygiene observation was carried out in October 2015. Under the PDCA cycle, we set up hand hygiene management working group to investigate the hand hygiene work before PDCA cycle was applied. Hand hygiene knowledge survey was carried out. Fishbone diagram was used to find out the causes of poor hand hygiene compliance. Based on these factors, improvement plans of hand hygiene were regulated and implemented. Then, continuous improvement was promoted according to PDCA cycle management process.
Results
After PDCA implementation, healthcare workers’ hand hygiene compliance (79.67%), correct handwashing rate (94.97%), and hand hygiene compliance before contacting the patients (85.96%), before sterile operation (68.14%), after contacting the patients (78.02%), after contacting patients’ blood or body fluid (85.96%), and after contacting patients’ surroundings (79.14%) were all significantly higher than those before the PDCA implementation (46.39%, 69.62%, 38.42%, 23.20%, 49.14%, 53.78% and 48.39%) (P<0.05). After the implementation of PDCA cycle, the amount of disinfectants consumed per day and the amount of hand sanitizer was 10.13 mL, significantly more than that before PDCA implementation (2.8 mL). The hospital was equipped with full hygiene equipment.
Conclusion
Applying PDCA cycle for continuous improvement of hand hygiene work can promote the hand hygiene compliance for medical staff.
ObjectiveTo compare the investigation results of compliance and accuracy of hand hygiene in medical staff achieved by Hospital Infection Management Department and Department Infection Management Teams, and analyze the reasons for differences of the results and take measures to improve the investigation ability of hand hygiene in hospitals.
MethodsWe statistically analyzed the results of compliance and accuracy of hand hygiene from January to December 2013 investigated by the infection management department and 25 infection management teams. Both the hospital and departments used "WHO Standard Observation Form". Single-blind method was used to observe the implementation of hand hygiene in medical staff.
ResultsThe hospital infection management department investigation showed that hand hygiene compliance and accuracy were 64.97% and 87.78%, respectively, while the investigation by infection management teams showed that hand hygiene compliance and accuracy were 90.54% and 93.37%, respectively. The differences between the investigation results of two-level organizations were statistically significant (χ2=286.2, P<0.001; χ2=532.6, P<0.001).
ConclusionWe should take measures to enforce the training of hand hygiene implementation and the observation method, and improve the guidance and assessment, promote investigators' working responsibility and observation ability, so that the survey data can accurately reflect the actual situation to urge medical staff to form good hand hygiene habits.
ObjectiveTo investigate the hand hygiene status of nursing staff in coronavirus disease 2019 (COVID-19) isolation ward, find out the difficulties and problems in hand hygiene implementation, and then put forward scientific and feasible suggestions to improve the compliance of hand hygiene.MethodsSelf-designed Questionnaire on Hand Hygiene Status of Nursing Staff in COVID-19 Isolation Ward was distributed through the Wenjuanxing, a platform to collect data. The questionnaire, which included general information, knowledge related to hand hygiene, and the status of hand hygiene in isolation ward, was distributed to the nurses working in isolation wards in Wuhan, Hubei Province from March 15th, 2020 to March 22nd, 2020.ResultsValid questionnaires were collected from 492 nurses. The difficulty in performing hand hygiene in the isolation ward was ranked ≥level 3 by 248 nurses (50.41%), the degree of which was divided into 10 levels (level 1 was no difficulty, level 10 was the most difficult). A total of 369 participants (75.00%) thought that wearing gloves for hand disinfection would damage the gloves. There were 161 participants who thought that gloves should be changed every 2 hours, accounting for the largest proportion (32.72%); while 226 participants actually changed gloves every 4 hours, accounting for the largest proportion (45.93%).ConclusionsThe difficulty of performing hand hygiene in isolation ward should be paid attention to. It is recommended to carry out further research on the replacement time of gloves.
Objective To analyze and discuss the research progress, hot spot, frontier and trend of the influence of high frequency hand hygiene on hand skin symptoms and hand microflora of health care workers by bibliometric analysis. Methods PubMed, Embase, Web of Science, Scopus, CNKI, Wanfang database, Chinese Biomedical Literature Service System and Cochrane Library were searched for related literatures on the effects of high-frequency hand hygiene on hand skin symptoms and hand microflora of health care workers from January 1st, 2014 to December 31th, 2024. NoteExpress 3.7.0.9296 and CiteSpace 6.1.R3 software were used to analyze the popular topics and generate a visual map to further refine research trends. Results A total of 1 607 articles were retrieved, and 126 were included after screening. The number of publications was relatively low before 2019, followed by a fluctuating upward trend from 2019 onward, reaching its peak in 2020. After 2020, the number of publications gradually declined and subsequently stabilized at a consistent level. Keyword co-occurrence analysis and keyword cluster analysis showed that the research focuses on the influence of high-frequency hand hygiene on hand skin symptoms and hand microflora of health care workers were hand eczema, hand sanitizer and protective equipment. The keyword burst analysis showed that the keyword with the strongest outbreak intensity was 2-propanol while the keyword with the longest outbreak duration was staphylococcus aureus. Conclusions In recent years, the influence of high frequency hand hygiene on hand skin symptoms and hand microflora of health care workers has gradually attracted attention. Current research highlights indicate that studies on different types of hand skin symptoms caused by high-frequency hand hygiene, the variation patterns of hand microbiota, the rationality of hand hygiene frequency in various medical work scenarios, and the development and application of protective hand sanitizer formulations or devices will become future research trends.
ObjectiveTo improve the hand hygiene compliance in medical staff via quality control circle (QCC) activities.
MethodsFrom January to May 2014, QCC activities were actualized throgh selecting the theme, ensuring the plans, confirming the target, investigating the actuality, validating the true reasons, finding out the countermeasure, ensuring the effect.
ResultsHand hygiene compliance, accuracy rate handwashing, and awareness rate before the QCC activities was 53.02%, 65.51% , and 45.56%, respectively; while after the activities was 79.91%, 87.39%, 95.44%, respectively; the differences were significant (P<0.001).
ConclusionQCC activities may improve hand hygiene compliance in the medical staff; at the same time, it can fully mobilize the enthusiasm of the medical staff , cultivate the spirit of teamwork , and promote quality improvement .
Objective
To improve hand hygiene executive ability of healthcare workers in medical institutions in Anhui Province by multi-modal interventions with the administrative intervention as the guide.
Methods
The PDCA management mode was adopted in a step-by-step implementation of plan, implementation, inspection, improvement, and effectiveness evaluation in Anhui Province from April 2014 to December 2016. The management indicators of hand hygiene before and after the intervention in 1 353 hospitals were investigated and evaluated.
Results
The overall evaluation of the hand hygiene at the end of the implemention showed that 85.29% (58/68) of the tertiary hospitals, 84.07% (227/270) of the second-class hospitals and 66.63% (595/893) of the primary-level hospitals had well-equipped hand hygiene facilities. About 92.65% (63/68) of the tertiary hospitals, 100.00% (270/270) of the second-class hospitals and 50.06% (447/893) of the primary-level hospitals had staff training of hand hygiene knowledge. The compliance of hand hygiene before and after intervention increased from 36.68% to 61.93%, the correct rate of hand washing increased from 37.60% to 89.28%, the awareness rate of related knowledge increased from 41.20% to 86.07%, and the dosage of hand disinfectant increased from 2.59 mL to 7.10 mL.
Conclusion
To take multi-model interventions with the administrative intervention as the guide, can effectively improve the quality of hand hygiene management and the executive force.
ObjectiveTo investigate the application and effect of quality control circle (QCC) in the management of hand hygiene for nurses in hemodialysis center.
MethodsQCC was applied in the management of hand hygiene in hemodialysis center from March 2013 to February 2014. Factors affecting the compliance and correctness of hand hygiene in hemodialysis nurses were analyzed, and counter measurements were established and applied. Moreover, effect of QCC management was also assessed.
ResultsAfter the application of QCC, the compliance and correctness of hand hygiene in hemodialysis nurses increased significantly from 41.02% to 88.46% (P<0.05) and 46.88% to 91.30% (P<0.05), respectively. Moreover, maneuver application, team spirit, professional knowledge, communication and cooperation among nurses were also increased by QCC management.
ConclusionThe application of QCC can not only increase the compliance and correctness of hand hygiene in hemodialysis nurses but also improve team cohesiveness, which is worth recommendation and promotion.
ObjectiveTo investigate the problems in the use of quick-drying hand disinfectants and formulate intervention measures to improve the hand hygiene compliance of nursing staff.MethodsFrom February 2014 to June 2016, the hand hygiene compliance of nursing staff was continuously observed according to the hand hygiene observation table recommended by the World Health Organization. The questionnaire on the use of quick-drying hand disinfectants, which passed the reliability and validity test, was used to find out the reasons leading to the low compliance rate of hand hygiene among nurses, and pertinent interventions were formulated. From November 2016 to December 2017, intervention measures were gradually implemented throughout the hospital, and the hand hygiene compliance of nursing staff was continuously observed again. Then we compared the compliance rate of hand hygiene and the compliance rate of hygienic hand disinfection among nurses in the second quarter of 2016 (before intervention) with those in the last quarter of 2017 (after intervention).ResultsThe compliance rates of hand hygiene and hygienic hand disinfection among nurses before intervention were 62.15% and 49.77%, respectively, and those after intervention were 91.64% and 90.80%, respectively. The differences were statistically significant (P<0.05).ConclusionThe factors affecting the hand hygiene compliance of nursing staff are identified through questionnaires and targeted intervention measures have effectively improved the hand hygiene compliance rate of nursing staff.
Objective To survey the knowledge of hand hygiene among nurses and to identify factors influencing the performance of hand hygiene.Methods A questionnaire of hand hygiene developed according to the Guideline for Hand Hygiene in Health Care Settings was used to investigate nurses’ knowledge about hand hygiene.Results The average score for nurses’ knowledge about hand hygiene was 18.59±2.19 out of a possible maximum score of 21. Knowledge about hand hygiene among nurses varied significantly in different departments (P=0.004). The main self-reported factors influencing the performance of hand hygiene were irritation and dryness caused by hand-washing agents (73.44%) and busy workload (65.53%).Conclusions Nurses generally have good knowledge about hand hygiene but are less aware of some hand hygiene indications. Effective measures are needed to improve compliance with hand hygiene among nurses.
Objective
To understand the effect of World Health Organization(WHO) multimodal hand hygiene improvement strategy on hand hygiene compliance among acupuncturists.
Methods
All the acupuncturists in departments (Department of Acupuncture, Department of Encephalopathy, Department of Orthopedics and Traumatology) with acupuncture programs in Xi’an Hospital of TCM were chosen in this study between September 2015 and August 2016. Based on the WHO multimodal hand hygiene improvement strategy, comprehensive measures were regulated among acupuncturists. Hand hygiene compliance and accuracy, and hand hygiene knowledge score were compared before and after the strategy intervention. Then, the effects of key strategies were evaluated.
Results
Overall hand hygiene compliance rate, accuracy and knowledge scores increased from 51.07%, 19.86% and 81.90±2.86 before intervention to 72.34%, 51.70%, and 98.62±2.92 after intervention (P<0.05). Hand hygiene compliance rates also increased in various occasions such as before contacting the patient, after contacting the patient, before acupuncture treatment, and before acupuncture needle manipulation (P<0.05).
Conclusion
Hand hygiene compliance in acupuncturists can be significantly improved by the implementation of WHO multimodal hand hygiene improvement strategy.
