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Improving hand hygiene compliance in the emergency department: getting to the point.

Scheithauer S, Kamerseder V, Petersen P, Brokmann JC, Lopez-Gonzalez LA, Mach C, Schulze-Röbbecke R, Lemmen SW - BMC Infect. Dis. (2013)

Bottom Line: The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs.Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively.Importantly, HH compliance improved significantly without increasing workload.

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Affiliation: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany. sscheithauer@ukaachen.de

ABSTRACT

Background: The emergency department (ED) represents an environment with a high density of invasive, and thus, infection-prone procedures. The two primary goals of this study were (1) to define the number of hand-rubs needed for an individual patient care at the ED and (2) to optimize hand hygiene (HH) compliance without increasing workload.

Methods: Prospective tri-phase (6-week observation phases interrupted by two 6-week interventions) before after study to determine opportunities for and compliance with HH (WHO definition). Standard operating procedures (SOPs) were optimized for invasive procedures during two predefined intervention periods (phases I and II) to improve workflow practices and thus compliance with HH.

Results: 378 patient cases were evaluated with 5674 opportunities for hand rubs (HR) and 1664 HR performed. Compliance significantly increased from 21% (545/2603) to 29% (467/1607), and finally 45% (652/1464; all p<0.001) in phases 1, 2, and 3, respectively. The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs. In parallel, the number of HR performed increased from 3 to 5 for non-surgical (p<0.001) and from 2 to 3 for surgical patients (p=0.317). Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively.

Conclusions: Our study provides the first detailed data on HH in an ED setting. Importantly, HH compliance improved significantly without increasing workload.

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Compliance: indication-specific analysis (according to the WHO concept).
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Related In: Results  -  Collection

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Figure 3: Compliance: indication-specific analysis (according to the WHO concept).

Mentions: Compliance before patient contact and aseptic tasks (indications 1–2) was lower compared to that after patient contact (indications 3–5). However, the greatest increase was observed for indications 1 and 2 (Figure 3).


Improving hand hygiene compliance in the emergency department: getting to the point.

Scheithauer S, Kamerseder V, Petersen P, Brokmann JC, Lopez-Gonzalez LA, Mach C, Schulze-Röbbecke R, Lemmen SW - BMC Infect. Dis. (2013)

Compliance: indication-specific analysis (according to the WHO concept).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750281&req=5

Figure 3: Compliance: indication-specific analysis (according to the WHO concept).
Mentions: Compliance before patient contact and aseptic tasks (indications 1–2) was lower compared to that after patient contact (indications 3–5). However, the greatest increase was observed for indications 1 and 2 (Figure 3).

Bottom Line: The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs.Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively.Importantly, HH compliance improved significantly without increasing workload.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany. sscheithauer@ukaachen.de

ABSTRACT

Background: The emergency department (ED) represents an environment with a high density of invasive, and thus, infection-prone procedures. The two primary goals of this study were (1) to define the number of hand-rubs needed for an individual patient care at the ED and (2) to optimize hand hygiene (HH) compliance without increasing workload.

Methods: Prospective tri-phase (6-week observation phases interrupted by two 6-week interventions) before after study to determine opportunities for and compliance with HH (WHO definition). Standard operating procedures (SOPs) were optimized for invasive procedures during two predefined intervention periods (phases I and II) to improve workflow practices and thus compliance with HH.

Results: 378 patient cases were evaluated with 5674 opportunities for hand rubs (HR) and 1664 HR performed. Compliance significantly increased from 21% (545/2603) to 29% (467/1607), and finally 45% (652/1464; all p<0.001) in phases 1, 2, and 3, respectively. The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs. In parallel, the number of HR performed increased from 3 to 5 for non-surgical (p<0.001) and from 2 to 3 for surgical patients (p=0.317). Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively.

Conclusions: Our study provides the first detailed data on HH in an ED setting. Importantly, HH compliance improved significantly without increasing workload.

Show MeSH