Hand Hygiene Compliance among Healthcare Workers at Baty Referral Hospital: Direct Observation

Keywords

Hand hygiene practice

Abstract

Introduction

Hand hygiene is a way of cleaning one's hands and substantially reduces potential microorganisms on both hands. Good hand hygiene, the simple task of cleaning hands at the right time and in the right way, can prevent healthcare-associated infections and their negative consequences, improve the quality of care, and save lives. However, ensuring good hand hygiene practices in hospital settings remains a challenge. A better understanding of hand hygiene practices among healthcare workers can help determine the most appropriate interventions to improve hand hygiene. Therefore, a study is proposed to assess hand hygiene compliance (HHC) at Baty Referral Hospital, Takeo Province, Cambodia, and make recommendations for improvements.

 Methods

A total of 52 healthcare workers with a total of 260 opportunities (five opportunities each) were included, including 5 medical doctors, 29 nurses, and 10 midwives from the medicine, pediatric, emergency, and maternity departments. They were directly observed by trained data collectors for their HHC with respect to the five moments: (1) before touching a patient, (2) before cleaning or an aseptic procedure, (3) after body fluid exposure risk, (4) after touching a patient, and (5) after touching patient surroundings. The data collected were analyzed via SPSS. 

Results

The overall HHC rate at Baty Referral Hospital was 87.3%, whereas it was 56.8% in 2018. The HHC rate was comparable among medical doctors, nurses and midwives, but it was significantly different among the four departments, with the highest rate (96%) for the emergency department. The HHC rate was 79.7%, the lowest at the moment “before touching a patient”, followed by 82.9% and 83.7% “after touching a patient or patient surroundings”, respectively. The HHC rate was highest at the moments “before the clean/aseptic procedure” and “after body fluid exposure risk,” at 94.4% and 94.8%, respectively.

Conclusion

Our findings show that HHC at Baty Referral Hospital has been reasonably good, with considerable improvement since 2018. However, further improvement is needed. Such improvement requires continuing efforts in awareness campaigns and training healthcare workers on hand hygiene, coupled with effective monitoring, supervision, and enforcement of rules, with particular attention to hand hygiene action at the moments “before and after touching a patient or patient surroundings”. We also recommend that hospitals regularly continue the five moments of hand hygiene assessment.