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Background: The simple act of hand washing has been proven to reduce the risk of acquiring hospital infection, especially with the current concern of Ebola viral disease. Hospital acquired infections have contributed significantly to overall mortality and morbidity and health care cost. They report that hand washing remains at an unacceptable low l...
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... is not statistically significant (χ 2 = 0.015, df = 1, P = 0.902). Table 5 showed that majority of 115 (82.1%) of the health professionals wash their hands before touching patients and of this number doctors constitute 22.1% while nurses made up to 60%. It is not statistically significant (χ 2 = 2.841. ...Citations
... In developing countries, HAIs burden is underreported or misclassified because expertise and resources required for complex diagnosis and surveillance activities is lacking (6). At any given time, the HAIs prevalence varies between 3.5-12.0% ...
Background: Hospital associated infections (HAIs) remain a significant cause of morbidity and mortality. And despite the simplicity of hand hygiene practice, an important preventive measure that has been proven to reduce the risk of acquiring and transmitting HAIs, Health care workers (HCW) compliance with the recommendations is of serious concern. Aim: The aim of this study was to determine the prevalence of hospital associated infections and HCWs compliance with hand hygiene practice in a tertiary hospital. Methods and material: This was a hospital-based descriptive cross-sectional study among 110 patients on admission selected using universal sampling, and 377 HCWs selected using a multistage sampling technique. Data collected with self-administered questionnaire for HCWs, interviewer-administered proforma for the patients and data extraction sheet for laboratory analysis. Data analyzed for descriptive statistics using SPSS version 20.0. Results: Patients' mean age was 32.8, IQR: 10.5-37.9 years. Majority, 56(50.9%) were females; Hausa/Fulani, 91(82.7%) and 37(33.6%) had only Qur'anic education while only 20(18.2%) had tertiary education. Health care workers' mean age was 31.8 5.3 years. Majority 227(60.2%) are females, and 267(71.8%) of the participants have received training on hospital infection control. Overall prevalence of HAIs was 42.7%, highest in surgical unit. Commonest HAIs being blood stream infections, and the least, Health Care Associated Pneumonia. Most of the infections were due to Staphylococcus aureus, 22(46.8%) and Pseudomonas aeruginosa, 14(29.8%). Highest hand hygiene practice was reported after contact with body fluid and highest non-compliance reported was before touching patient. Hand hygiene compliance rate was 49.6% and main reasons to non-compliance were high work load, lack of running water and soap, and regular use of hand gloves. Conclusions: Prevalence of HAIs was reportedly high, and low hand hygiene compliance and rate despite majority of the HCWs having received training on Hospital infection control. To reduce the prevalence and the associated burden of HAIs, there is need to put in measures to improve compliance to quality hand hygiene practice by health workers.
... ( Table 8). [13,17] The findings in this study may not be unrelated to scattered seminars and sensitization talks within the facility on Lassa fever outbreaks which presents yearly at the peak of dry season and very recently the COVID-19 infection. These seminars always emphasized the hands of HCWs as major carrier of infectious agents. ...
... Also, hand hygiene facilities are readily available and staff may have no excuse not to follow the SOP. [15] However, other studies in Lagos and Kano did not find any association between profession and good knowledge of handwashing mainly because only doctors and nurses were recruited and compared in those studies [13,16]. Previous studies have also documented an association between previous training and good practice of handwashing, while a report from Juba, South Sudan refuted such association [16,[22][23][24]. ...
Background: The most common means of transmission of Healthcare-Associated Infections (HAIs) is the contaminated hand of Healthcare Workers (HCWs), proper handwashing by HCWs is the best method of halting this transmission, however, there is poor adherence to the practice of the simple handwashing procedure in many health facilities. Aims: To assess the knowledge and practice of proper handwashing, to identify the factors impeding adherence to its good practice among HCWs and to identify the handwashing and hand drying facilities available to these HCWs. Study Design: This is a descriptive cross-sectional study. Place and Duration of Study: The study was carried out at Federal Teaching Hospital, Ido-Ekiti (FETHI), Southwestern Nigeria between July 2020 and December 2020. Methods: The study involved 328 randomly selected HCWs. Data was collected using pretested self administered questionnaires, entered into Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Only 31.10% of respondents had good knowledge of handwashing while 80.18% had good practice of handwashing. Longer stay in service and being a doctor or nurse were associated with good knowledge and good practice of handwashing. Only 16.46% of respondents had previous training on handwashing within 3 years prior to this study. Previous training on handwashing was associated with good knowledge of handwashing (P=.001). Up to 68.60% of respondents used stored water and soap for handwashing. The most common hand drying facility reported in the study was common towel, no respondent ever used paper towel. The most common reason given for poor adherence to handwashing practices was the busy schedule. Conclusion: Hospital managers must prioritize the regular provision of handwashing and hand drying facilities for their centre, in addition to organizing regular hand hygiene training for HCWs, to improve their knowledge and practice of handwashing and thus reduce the rate of HAIs
... All the respondents in this study accepted that handwashing will reduce the risk of infection; this observation was similar to others reported among medical students [8] and health professionals in a tertiary health center. [9] However, only 24.4% of them were aware of the Global Handwashing Day; this is a far cry from the 46% reported among medical students [8] and 64.3% reported among health professional. [9] This is not surprising considering their level of exposure and educational qualification though 68.9% of the respondents in this study had secondary school certificate qualification that are expected to be able to read and write, this is often not the case in most developing countries with poor educational structures. ...
... [9] However, only 24.4% of them were aware of the Global Handwashing Day; this is a far cry from the 46% reported among medical students [8] and 64.3% reported among health professional. [9] This is not surprising considering their level of exposure and educational qualification though 68.9% of the respondents in this study had secondary school certificate qualification that are expected to be able to read and write, this is often not the case in most developing countries with poor educational structures. [10][11][12] Similarly, none of the respondents could either correctly mention the date of Global Handwashing Day or the five moments in handwashing and only two respondents could correctly mention the steps in handwashing correctly; this finding is disturbing considering their job schedules; therefore, they stand the risk of either getting infected or transmitting infection to others, patients inclusive. ...
... However, they all reported washing their hands after using the restroom; this is similar to previous reports. [8][9] Only 13.3% of the respondents in this study reported washing their hands before wearing gloves; this is lower than the 56.1% reported by Braimoh and Udeabor; [13] however, all the respondents reported washing their hands after removing gloves; the powder stains could have accounted for the desire to wash their hands afterward. Similarly, only 20% of respondents in this study washed their hands before touching patient which was similar to that reported by Opara et al.; [14] however, almost all reported washing their hands after patient contact or handling patient secretions which was similar to previous studies; [8,9,15,16] therefore, it appeared their action and intention was for self-preservation and protection; rather than to prevent transmission of infection to patients from their contaminated hands. ...
Introduction: Handwashing reduces the risk of transmission of infection; greater emphases are often placed on the practices of doctors and nurses; however, activities of other staffs such as laboratory and ward attendants influence treatment outcome; therefore, this study seeks to determine the hand hygiene practices among laboratory and ward attendants in a federal health institution. Materials and Methods: This was a cross-sectional descriptive study involving laboratory and ward attendants and clinical assistants. Participants were selected by convenience sampling and data were collected using pretested questionnaire. Result: Forty-five respondents were involved in this study. All the respondents (100%) who are aware of handwashing can reduce the risk of acquiring or transmitting infection. Most (84.4%) respondents could not correctly mention the steps in handwashing, "my five-moments in handwashing," and the date of the Global Handwashing Day. Almost all the respondents (97.8%) washed their hands with water and soap at most times and only one (2.2%) used water only for handwashing. Only 9 (20.0%) of the respondents wash their hands before touching patients, while all respondents wash their hands after touching patients. Similarly, 44 (97.8%) of the respondents wash their hands after handling patient materials. All of the respondents (100%) reported washing their hands after using the restroom. Conclusion: The study showed that although most of the respondents wash their hands with soap and water, they do not know the steps in handwashing, suggesting the need for health education on the steps and procedures for handwashing.
... [25][26][27] Furthermore, most of the respondents (87%) in this study were aware of the critical moments in hand moment; this pattern was similar to that reported by Datta et al., [27] but higher than the 56% reported by Aigbiremolen et al. [20] However, most respondents got information on hand hygiene from relations; this highlights strong family ties which is prevalent in most developing society, this may be significantly influenced by our culture, religion, and beliefs; [28] therefore, health authorities and nongovernmental agencies need to do more in public enlightenment because some of these practices may be harmful, furthermore, they need to explore on the benefits of integrating some of these practices with the goal of increasing community acceptance of health policies. About 44.8% of the respondents had heard of the Global Handwashing Day; this finding was similar to the 46% reported among university medical students, [29] but slightly lower than the 64.4% reported by Mohammed et al. [30] among health professionals. Furthermore, most of our respondents (51.7%) could correctly state the date earmarked for celebrating Global Handwashing, surprisingly, this was higher than that reported among health professionals (15%) [30] and medical students (11.7%). ...
... Furthermore, most of our respondents (51.7%) could correctly state the date earmarked for celebrating Global Handwashing, surprisingly, this was higher than that reported among health professionals (15%) [30] and medical students (11.7%). [29] This finding is worrisome because the professionals who are supposed to be stakeholders and advocates should be more knowledgeable. Majority of respondents in our study used soap and water (72.4%) for handwashing; this is different from the findings of Datta et al. [27] and Aigbiremolen et al. [20] who reported the use of water alone as the most common handwashing agent. ...
Introduction: Hand washing has been proven to reduce the risk of acquiring infection; this is why every 15th October is being set aside as Global Hand washing Day, which aims at improving global awareness on the importance of hand washing. Materials and Methods: The study was cross‑sectional, parents/caregivers were
consecutively recruited over 8 months, and pretested questionnaire was administered by the researchers and trained assistants. Results: There were 102 (32%) males and 217 (68%) females with a male‑to‑female ratio of 1:2.1. A total of 279 (87.5%) respondents reported that they were aware of the moments of hand hygiene. Their relations (38.3%) were the most common source of information on
hand hygiene. However, soap and water (72.4%) were the predominant items used for handwashing. Furthermore, 317 (99.1%) respondents were incorrect on the steps of hand washing technique. All respondents (100%) reported washing their hands after using the restroom. However, their educational and social status had no
significant relationship with their ability to mention the steps in hand washing and the critical moments in hand hygiene, respectively, (educational status: ‡Fisher’s exact = 0.440; P = 1.00, and $Fisher’s exact = 3.308; P = 0.282, respectively) and (social class: ‡‡Fisher’s exact = 0.756; P = 1.00 and $$Fisher’s exact = 1.232; P = 1.00, respectively). However, there were statistically significant relation with adhering to the principles of handwashing (educational status: †χ2 = 7.835; df = 2; P = 0.019) and (social class: ††χ2 = 7.952; df = 2; P = 0.019), respectively. Conclusion: Majority of the respondents wash their hands especially after soiling with dirt; and water and soap were mostly used; however, the technique of hand washing was poorly understood by caregivers and this was shown to be less influenced by their educational or social status.
... This observation is similar to previous reports by Mohammed and Aliyu and Abdulsalam et al.; this highlights poor participation of health institution in marking this day. [6,9] Soap and water were the most common hand-cleaning agents in this study; this observation is similar to previous reports, but differed from that of de Wandel The WHO recommends the use of alcohol-based handrubs/sanitizers; however, when the hand is visibly soiled, the hands must be washed with soap and water first before proceeding to use a hand-rub. There are varied reports of its acceptances among health-care professionals. ...
... [22] However, 47.9% of respondents in our study had their personal hand-rub which is similar to previous reports. [6,9] While 76% of the respondents reported adhering to the principles of hand hygiene, only 45.8% could correctly mention the steps in hand-washing. This highlights the need to reeducate them on the steps in hand hygiene; however, the relationship of teaching hand-washing techniques and ability to mention the steps in handwashing did not show any statistical significance in this study. ...
... Most respondents in this study washed their hands before and after touching patients and also before and after wearing gloves; this finding was similar to that of Mohammed and Aliyu in their study among medical students and that of Abdulsalam et al. in their study among health professionals but our observation was higher than that reported by Braimoh et al. in their study among community health workers; this is because nurses are better educated and informed than community health workers, hence a better knowledge base and clinical practice is expected from nurses. [6,9,23] ...
INTRODUCTION: Hand is an important medium of infection transmission. This is further worsened in the hospital setting where sources of contamination are abundant. Nurses play a vital role in
patient care, and while doing so, they are often exposed to health hazards. Therefore, they may act as conduits for transmitting infectious diseases to themselves, family members, and other patients. Good hand hygiene is a prerequisite for infection control; therefore, the objective of this study is to determine the knowledge and practices of hand hygiene among nurses in our institution.
MATERIALS AND METHODS: This was a cross-sectional study involving 113 nurses and it was conducted over 12 weeks; it was questionnaire based, which was pretested and self-administered.
Convenience sampling was adopted. RESULTS: Data from 96 (85%) respondents consisting of 41 (42.7%) males and 55 (57.3%) females
with male:female ratio of 0.7:1 were analyzed. All respondents reported using water and soap for hand-washing. Furthermore, majority (59%) of the respondents were not aware of the five moments
of hand hygiene. Although majority (76%) reported adhering to the principles of good hand hygiene, 54.2% of the respondents could not correctly mention the steps of hand-washing technique. Sixty-six
(68.8%) respondents wash their hands before attending to patients; however, almost all (99%) of the respondents wash their hands after attending to patients and after removing hand gloves. Similarly, all respondents wash their hands after using the restroom. CONCLUSION: The act of hand-washing is common among respondents in this study; however, the major challenge is with practicing the correct technique involved in hand-washing. Furthermore, knowledge of the critical moments of hand-washing was also deficient among most of the respondents.
... This was a cross-sectional study involving doctors at Federal medical Centre Birnin Kebbi; it was conducted over 8 weeks from September 2015 to November 2015. A sample size of 58 was calculated from a knowledge base of 64.4% from previous study; [7] and the Fishers formula for population of <10,000 [8] (the estimated total population of respondents available at the time of the study was 70); furthermore, a convenience sampling method was adopted for their recruitment. This study was questionnaire-based and it was pretested and self-administered; relevant information such as age, sex, profession, and years of working experience were contained, others were; awareness of Global Hand Washing Day, knowledge on hand-washing technique, steps in hand washing, ability to list the five moments in hand washing and principles of hand washing. ...
... [10] This study showed that almost half of the respondents (44.6%) were unaware of the WHO Global Hand Washing Day and among the 25 respondents who reported been aware of the day, only 9 (36%) could correctly state the date; this showed that the general awareness of Global Hand-Washing Day was low; this observation was similar to previous reports from studies among health trainees and health professionals. [7,11] This means there is insufficient publicity of this very important day in our health institutions and medical schools; therefore government and nongovernmental to significantly increase the compliance rate. [14,15] Other general measures such as behavioral changes among health professionals and practical demonstrations and participation sessions by attendees should be encouraged. ...
... This observation was similar to previous reports. [7,11] WHO recommends the use of alcohol-based hand-rubs for hand cleansing except in visibly dirty hands in which soap and water is preferable, [16] but soap and water was the common agent used for cleansing in this study. This observation was similar to previous reports [7,11,17] but differed from those of De Wandel et al. [18] Although over 95% of the respondents liked and agreed to use alcohol-based hand rub, only 44.4% of them had their personal hand-rub. ...
INTRODUCTION: Hand hygiene is an integral part of personal hygiene; poor hand hygiene practice may result not only in self-hurt but also may serve as a vehicle for transmission of infection among patients. Hence, knowledge of proper hand hygiene practice will significantly reduce the burden of infectious diseases.
MATERIALS AND METHODS: This was a cross-sectional study involving doctors at Federal Medical Centre Birnin Kebbi; it was conducted from September 2015 to November 2015. Convenience sampling method was adopted. Pretested self-administered questionnaire based was used; relevant information such as age, sex, profession, years of working experience, awareness of Global HandWashing Day, hand-washing technique, steps in hand washing, ability to list the five moments in hand washing, and principles of hand washing were obtained.
RESULTS: There were 33 males and 12 females with a male to female ratio of 2.8:1. All respondents believed hand washing reduces the risk of transmitting or contracting infections. Soap and water was the most common agent for hand cleansing, majority of the respondents (86.7%) had been taught on the technique of hand washing; however, only 19 (42.2%) of them wash their hands before examining patients; but all the respondents (100%) wash their hands after examining patient or handling their secretions; similarly, they all reported washing their hands after using the restroom. Almost all of the respondents (97.8%) use water and soap for hand washing. Furthermore, only 44.4% of the respondents had their personal hand rub.
CONCLUSION: Soap and water was the most common agent for hand cleansing, and there was poor utilization of hand rub; and most respondents did not wash their hands before patient contact.
Background: One of the leading causes of hospital associated infection is providing patient care withcontaminated hands as a result of transmission of microorganism from health care provider to patientsand others. Hand washing is the most important and simple act of reducing the spread of transmission ofinfectious agent and reducing hand flora. Materials and Methods: The study was done to evaluate theeffects of medical hand washing on hand flora among staff nurses working in a selected hospital, Bengaluru.One group time series design was used. Swabs were taken from a randomly selected sample of 25 nursesworking in medical ward for hand flora analysis. Results: Study results revealed that before hand washingthere were many colonies of hand flora were found. After medical hand washing there was a significantreduction in the number of colonies of the hand floras between the pre-test mean (O1= 10.02) and post-testsmean (O2= 4.23, O3 = 4.02 and O4 = 2.36) and was found to be statistically significant at H= 83.288 andP value = 0.001. Conclusion: Medical hand washing is an effective technique to reducing the hand floraamong the staff nurses working in the different medical wards of hospital.
Compliance with recommended hand hygiene among healthcare providers is important in the prevention of morbidity and mortality associated with hospitalacquired infections including drug resistant microorganisms. This study aimed to determine the reported knowledge and hand hygiene practices among healthcare workers in Specialist Hospitals in Kano, Nigeria. Descriptive cross-sectional study design was used to study 302 healthcare workers in the specialist hospitals in Kano. Data was collected using semi-structured self-administered questionnaire and analyzed at univariate, bivariate and multivariate levels using IBM SPSS version 22. The age of the respondents ranged from 18 to 59 years with a mean of 31.4±9 years. Up to onethird (36.1%) of the respondents had poor knowledge despite the reported hand hygiene practice of 78%. Use of Alcohol Based Hand Rub and soap and water constituted 26.7% and 15.7% respectively. There was statistically significant association between working in MMSH, working in Pediatrics wards, CHEW cadre, and attendance of hand hygiene training in the last 3 years and having good knowledge of hand hygiene. Hand hygiene training was found to improve hand hygiene knowledge [AOR=1.58, 95% CI= (1.01-2.5)] and practice [AOR=1.12 95%CI= (0.64-1.99)]. Reported knowledge of hand hygiene was poor but the practices were encouraging and associated with formal training of healthcare workers on hand hygiene. Therefore, Hospital management should ensure regular hand hygiene training and re-training among healthcare workers.
Compliance with recommended hand hygiene among healthcare providers is important in the prevention of morbidity and mortality associated with hospital-acquired infections including drug resistant microorganisms. This study aimed to determine the reported knowledge and hand hygiene practices among healthcare workers in Specialist Hospitals in Kano, Nigeria. Descriptive cross-sectional study design was used to study 302 healthcare workers in the specialist hospitals in Kano. Data was collected using semi-structured self-administered questionnaire and analyzed at uni-variate, bivariate and multivariate levels using IBM SPSS version 22. The age of the respondents ranged from 18 to 59 years with a mean of 31.4±9 years. Up to one-third (36.1%) of the respondents had poor knowledge despite the reported hand hygiene practice of 78%. Use of Alcohol Based Hand Rub and soap and water constituted 26.7% and 15.7% respectively. There was statistically significant association between working in MMSH, working in Pediatrics wards, CHEW cadre, and attendance of hand hygiene training in the last 3 years and having good knowledge of hand hygiene. Hand hygiene training was found to improve hand hygiene knowledge [AOR=1.58, 95% CI= (1.01-2.5)] and practice [AOR=1.12 95%CI= (0.64-1.99)]. Reported knowledge of hand hygiene was poor but the practices were encouraging and associated with formal training of health-care workers on hand hygiene. Therefore, Hospital management should ensure regular hand hygiene training and retraining among healthcare workers.
Background
Poor compliance with recommended hand hygiene practice by healthcare workers is an emerging
Public Health threat that is associated with a significant morbidity, mortality, and spread of
multidrug-resistant microorganisms. This study therefore, assessed and compared the impact of
voice reminder on compliance with recommended hand hygiene practice among healthcare
workers in Kano metropolis.
Methodology
It is aquasi-experimental study design that assessed the baseline and post-intervention
compliance with recommended hand hygiene practice among healthcare workers using the WHO
checklist for observation of 5- moments of hand hygiene. A qualitative component was also
employed to identify the facilitators and barriers to their compliance with hand hygiene. A total
of 408 (204 in each arm) baseline and post-intervention observations for hand hygiene
compliance were conducted in two hospitals in Kano selected using a multi-stage- sampling
technique. Voice reminders were installed in the intervention hospital, and post-intervention
observation was conducted three months after the introduction of voice reminder using the same
WHO tool used for baseline observation. SPSS version 20 was used for data analysis.
Relationship between variables was tested using χ
2
and McNemar test within the groups at 0.05
α-level of significance, and logistic regression was used to adjust for the effect of confounding.
Qualitative data were manually analyzed using thematic analysis and triangulated with the results
of the observation.
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Results
Baseline compliance with hand hygiene among healthcare workers in the intervention and
control hospitals were (31.4%) and (48.0%) respectively. Barriers to non-compliance identified
during KII and FGDs were lack of hand hygiene training, non-availability of water, soap and
alcohol-based hand rub. Post-intervention compliance in the intervention and control hospitals
were found to be (78.0%) and (65.2%) respectively. Voice reminder intervention improved the
overall compliance with recommended hand hygiene practice by (+148%) in the intervention
hospital compared with (+36%) in the control hospital. There was a significant increase in
compliance with recommended hand hygiene practice among healthcare workers in the
intervention hospital, three months after the introduction of voice reminder intervention
compared with the baseline compliance from Monday to Friday (+208.0%, P=0.01), during
morning shift (+253.0%, P<0.001), among nurses (+208.4%, P<0.001) than other healthcare
workers while in the control hospital, a significant increase in compliance was found during
weekends (+171.2%, P<0.001) than working days.
Conclusion:
Voice reminder intervention significantly improved hand hygiene compliance among healthcare
workers in the intervention hospital compared with the control hospital.
Recommendation
The findings suggested the need for the provision of voice reminder in the hospitals by
stakeholders, thereby improving compliance with hand hygiene among healthcare workers and
reducing the burden of hospital-acquired infections.
Keywords
Hand hygiene, compliance, healthcare workers, tertiary hospitals, Kano
