Infection Preventionist Hoag Memorial Hospital Presbyterian Mission Viejo, California, United States
Disclosure(s):
Graham N. Gerrard, CIC: No financial relationships to disclose
Background: Hand hygiene using alcohol-based hand rub (AHBR) is the preferred method of hand sanitation for most healthcare interactions. Emphasis has been placed on when to do hand hygiene, following the World Health Organization’s (WHO) Five Moments, but how to do hand hygiene using the proper six-pose technique remains a practice gap for healthcare workers (HCW). The objective of this study is to evaluate the impact that proper hand hygiene technique using AHBR has on organism reduction from HCW hands.
Methods: The hands of 120 HCW from inpatient and emergency units at a two-campus acute care hospital were cultured before and after hand hygiene with AHBR. Participants were observed while performing hand hygiene, recording how many and which of the six hand hygiene poses were completed. Specimens were incubated for 48 hours and colony forming unit (CFU) counts were performed. Breakpoint interpretations of CFU reduction were developed giving each participant a grade of excellent, good, or poor hand hygiene. Data analysis looked at the number of poses performed compared to the interpretation grades and the percentage of organisms removed.
Results: 37 participants completed all six poses, they were given an excellent grade in 41% of samples, with a median organism reduction of 93%. 82 participants did not complete all the poses, they were given an excellent grade in 26% of samples, with a median organism reduction of 87%. One specimen was deemed a contamination and excluded from the analysis.
Conclusions: Performing hand hygiene using the proper technique has a positive effect on AHBR efficacy. However, the compliance with healthcare workers using the technique is low even though this facility performs training at hire and periodically. New methods of training and continuous re-education of technique need to be developed to build a comprehensive hand hygiene program that maximizes the effectiveness of AHBR.
Learning Objectives:
Visualize the effect that using the proper hand hygiene technique has on reduction of organisms from healthcare worker hands.
Recognize the importance of including technique training in their hand hygiene program.
Explore new methods of training and re-education of hand hygiene technique for healthcare workers.
