Research for infection protection
  • germs
  • Adenovirus
  • Aspergillus niger
  • Bovine virus diarrhea
  • Clostridium difficile
  • Candida albicans
  • Candida albicans
  • Coronavirus
  • Corynebacterium
  • Escherichia coli
  • Helicobacter pylori

Author: Scheithauer et al. (2012) Source: Scheithauer et al. (2012) Improving hand hygiene compliance rates in the haemodialysis setting: more than just more hand rubs. Nephrol Dial Transplant 2012; 27(2):766–770.

STUDY

Scheithauer et al. (2012)

Improving hand hygiene compliance rates in the haemodialysis setting

Background: Haemodialysis patients have a high risk of developing healthcare-associated infections and being colonised with multidrug-resistant microorganisms. Hand hygiene is considered the effective tool to prevent healthcare-associated infections. Optimising standard operating procedures (SOPs) for dialysis connections and disconnections may help reducing infections. The study aimed to determine the number of overall and indication-specific hand rubs (HR), indications for HR, and the calculated compliance rates in order to precisely analyse dialysis-associated hand hygiene and optimise hand hygiene compliance.


Method: The prospective, three-phase, observational intervention study was conducted at the University Hospital of the RWTH Aachen University between March and September 2010. Hand hygiene indications were classified according to the guidelines of the World Health Organization (WHO). Using a modified version of these guidelines, indication-specific hand hygiene behaviour was directly observed in a patient-directed manner and documented accordingly. Observations were carried out during three observation phases (phase I, II, III), which were divided by two 2-week intervention phases (intervention I, II). The predefined interventions (individual and group courses on hand hygiene, direct observations with feedback, compiling and implementing SOPs, optimised dispenser infrastructure, use of disinfectant bottles for the gown pockets as well as feedback on interim results as a training and motivational tool) focused on problems observed during the preceding study phase. While intervention I primarily addressed the connection process, intervention II mainly addressed the disconnection procedure and further improved the distribution and the practical implementation of the SOP for connections as well.


Results: In the course of the study, a total of 8,897 indications for HR were observed. The mean number of performed HR per dialysis procedure increased from 6 before interventions (phase I) to 9 after interventions I and II (phase III), whereas the indications for HR per dialysis procedure decreased from 21 (phase I) to 15 (phase III). The overall HR compliance improved from 30% in phase I to 62% in phase III. Considering all three observation phases, the highest compliance rate was achieved for the indication ‘before touching a patient’ in phase III (88%). The greatest improvement of 148%, however, was observed for the indication ‘before clean/aseptic procedures’ (from 21% in phase I to 52% in phase III), which is the indication with the greatest impact on preventing healthcare-associated infections.


Conclusions: The study demonstrates that optimised hand hygiene SOPs combined with a set of interventions reduced the number of recontaminations and improved hand hygiene compliance in the haemodialysis setting considerably.


Source: Scheithauer et al. (2012) Improving hand hygiene compliance rates in the haemodialysis setting: more than just more hand rubs. Nephrol Dial Transplant 2012; 27(2):766–770.

Please click here to view the original study.