Coming clean on hand hygiene

Abstract

Introduction: Hand hygiene is universally recognized as one of the most effective ways to reduce the cross-transmission of hospital acquired infections. Successful strategies to improve hand hygiene compliance require a baseline knowledge of hand hygiene practices. Methodology: A direct observational method was used to collect data about hand hygiene practices amongst medical doctors by a group of trained medical students during their clinical assignments. To prevent any bias during the observation, the purpose of the study was not disclosed to the doctors; they only knew that they were being observed for infection control practices. A structured data collection sheet was used to direct the observations. Data on hand hygiene practices was collected during routine clinical work over a number of weeks. Observers recorded the professional grade of physician observed, speciality, location, activity performed, method used, and facilities available. Results: A total of 898 observations were recorded. Overall compliance before and after doctor-patient contact was 22.7% and 33.5% respectively. Within specialties, hand hygiene practices were lowest in obstetrics and gynaecology and highest in specialized surgical units. Poorest compliance was evident in house officers before patient contact, while the most compliant was the registrar group, following examination. Alcohol hand rub was the preferred method in the wards whilst hand washing was mainly utilised in the outpatient setting. Conclusion: Hand hygiene amongst doctors in St Luke's Hospital is low and could be a factor in the high MRSA endemicity.