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Hand hygiene in the emergency department: degree of compliance, predictors and change over time




S√°nchez Pay√° J, Hern√°ndez Garc√≠a I, Camargo √Āngeles R, Villanueva Ruiz CO, Mart√≠n Ruiz AC, Rom√°n F, Garc√≠a Shimizu P, Llorens P



Servicio de Medicina Preventiva, Servicio de Urgencias. Hospital General Universitario de Alicante. Spain. Servicio de Medicina Preventiva y Salud Pública, Complejo Asistencial Universitario de Salamanca, Spain.



Objective: To determine the degree of compliance with hand hygiene measures,
predictors, and change over time in an emergency department.
Methods: Cross-sectional study between 2005 and 2010 in the emergency
department of Hospital General Universitario de Alicante, Spain. An observer assessed
staff compliance with the World Health Organization’s 5-moments approach to hand
hygiene. We also studied the association between compliance and such potential
predictors as age, sex, availability of pocket-sized alcohol hand rubs, and attendance
at training sessions; the √∑2 test was used to compare compliance between the 2005-
2007 and 2008-2010 periods. A multivariate logistic regression model was then
constructed.
Results: Compliance was observed in 41.1% in the 2005-2007 period and 42.3% in the
2008-2010 period. Hygiene at the moment before touching a patient improved
significantly (16.3% in 2005-2007 and 29.8% in 2008-2010). The moment of best
compliance was after touching patient surroundings (67.1% in 2008-2010). Factors
associated with hand hygiene compliance changed over time with the exception of a
stable association in both periods between hygiene at the moment before touching a
patient and the availability of pocket-sized alcohol hand rubs.
Conclusions: Emergency departments should seek improvements in hygiene by
providing training on the importance of hand hygiene before a patient is touched,
particularly before clean/aseptic procedures, and by promoting the use of pocket-sized
alcohol rubs.


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