Hand hygiene compliance and HAIs

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Hand hygiene compliance and HAIs-hand hygiene is a fundamental prerequisite for every doctor and paramedic staff working in a hospital setting today. Keeping in mind the severe outcomes of the spread of hospital-associated infections(HAIs)  it is apparent that hand hygiene should be emphasized.

The ascending incidence of nosocomial infections and their intricacies can be precluded by raising awareness about hand hygiene practices. 

Hand hygiene compliance and HAIs

are a foremost difficulty for patient safety and its consequences can result in prolonged hospital stay, long-term disability, increased resistance of microorganisms to medicines and antimicrobial agents, enormous extra financial stress for the health system, high expenses for patients and their families, and morbidity and mortality.

HAIs are also dangerous to handle in situations of major crises

like pandemics, epidemics, natural disasters, etc. and are a constant threat to healthcare providers. The risk to acquire HAI is a global problem  and extends throughout healthcare facilities and systems worldwide, but the real burden stays unidentified in many countries, particularly in developing countries

HAIs are major obstacles to achieving the paragon of the healthcare system. These infections pose a profound threat to millions of people across the world and according to a research there is a soaring number of 37,000 deaths from 4,544,100 infections in the European Union annually, and 100,000 deaths from 2,000,000 infections in the US per year.

The absence and inadequacy of proper hand hygiene practices play a role as a source of the spread of common HAIs that may affect the integumentary, urinary, respiratory, and gastrointestinal tract, as well as surgical sites.

Despite the clarity and convenience of this hand hygiene strategy and the frequent provision of all kinds of information and education about this issue, hospital healthcare workers’ compliance with hand hygiene guidelines is generally insufficient. Doctors and especially paramedic staff is in direct contact with the patient and tackle most of the patient care interactions, and therefore,  more opportunities to practice hand hygiene.

Some of the barriers to hand hygiene compliance reported by paramedic staff and doctors are listed below:

  • Lack of resources
  • Lack of proper education and communication
  • Lack of availability of hand-washing stands
  • Lack of adequate hospital infection control policy and implementation
  • Deficiency in the integration of proper feedback
  • Lack of provision of soap, hand sanitizers, and scrubbers.
  • Adherence to the ritual behavior
  • Absence of motivating factor to prompt hand washing
  • Personal reasons such as applying irritating and drying solutions for hand disinfection identified as a barrier.

Factors associated to hand washing compliance among healthcare providers:

According to CDC, Hospital-Acquired Infections (HAI) are among the most common medical events causing morbidity and mortality, particularly among NICUs, pediatric patients, ICUs, HDUS, and in children and older people generally.  Proper hand hygiene can prevent up to 1 million casualties annually and reduce HAI by up to 40%. 

The WHO states that hand hygiene is an essential and cost-effective intervention in the prevention of infection and the spread of disease.

But, only 50% of all medical care workers wash or sanitize their hands precisely. There are multiple reasons that were outlined after several observational and experimental studies which indicated that hand washing is used as self-protection when encountering to a potential risk happens. Adherence to the ritual behavior and lack of flexibility or adaptation to the new techniques is also one of the factors which proves that facilitation of handwashing compliance is dependent on alterations in behavioral patterns.

Moreover, Handwashing was considered to be time-consuming by some of the paramedics and some stated that they often forget to perform the proper steps because they are under stress.

The studies conducted to determine the influential factors associated with hand-washing compliance among healthcare providers outlined the following features:

1) Time restrictions and hectic routine with a lot of things to juggle in a particular duration. 

2) Hand hygiene as self-protection for nurses and self-assessment or critique of risk.

3) Awareness of being supervised.

4) transforming  knowledge into action and modifying intention into behavior.

5) Social stress and role modeling.

Improved education and provision of reinforcements such as hand washing stands, soap, alcohol-based hand sanitizers, virtual posters of hand washing steps, and other necessary updates of hospital infection control strategies, goals, and the relation between HAI and hand hygiene to the paramedic staff may result in overall reduction.

handwashing steps
(credit: Freepik)

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