NICU Healthcare Workers Hand Hygiene Compliance during 6 Months of Direct Observation
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Introduction: Hospitalized neonates are at risk of developing nosocomial sepsis, a systemic infection due to unhygienic healthcare, especially in Indonesia where healthcare-associated infection incidence rate is 5.9%-8.3%. Hand hygiene by healthcare workers is an effective measure to prevent it. This study aimed to understand the healthcare workers' hand hygiene compliance towards WHO guidelines 2009 in Dr. Soetomo General Hospital NICU.
Methods: This research was an observational study. The healthcare workers' hand hygiene compliance was obtained through 6 months of direct observation, from November 2018 to April 2019, with doctors and nurses who agreed to be observed and present during the observation period as samples. The observation was recorded with WHO observation form, and processed with Microsoft Excel 2013 to obtain compliance rate.
Results: Overall, the compliance of healthcare worker in NICU Dr. Soetomo General Hospital during the 6 months of study was 84%. Nurses' compliance was higher (87%) than doctors' (78%). Compliance to My 5 Moments of Hand Hygiene indications varied from 82% for moments before patient contact to 93% for moments after patient contact.
Conclusion: In conclusion, hand hygiene compliance of healthcare workers in Dr. Soetomo General Hospital NICU varied between profession categories and each indication. To maintain and improve hand hygiene compliance, intervention in healthcare workers' behavior is needed, so that healthcare-associated infection can be better prevented.
World Health Organization (WHO). WHO | MDG 4: Reduce Child Mortality [Internet]. WHO. World Health Organization; 2015 [cited 2019 May 6]. Available from: https://www.who.int/topics/millennium_development_goals/child_mortality/en/
Voller SMB, Myers PJ. Neonatal Sepsis. Clin Pediatr Emerg Med [Internet]. 2016 Jun 1 [cited 2019 Oct 2];17(2):129–33. Available from: https://www.sciencedirect.com/science/article/pii/S1522840116300064 doi: 10.1016/J.CPEM.2016.03.006
Chhapola V, Brar R. Impact of an Educational Intervention on Hand Hygiene Compliance and Infection Rate in a Developing Country Neonatal Intensive Care Unit. Int J Nurs Pract. 2015;21(5):486–92. https://doi.org/10.1111/ijn.12283
Mahfouz AA, Al-Azraqi T., Abbag FI, Al-Gamal MN, Seef S, Bello CS. Nosocomial Infections in a Neonatal Intensive Care Unit in South-Western Saudi Arabia. East Mediterr Heal J [Internet]. 2010 [cited 2019 Oct 27];16(1):40–4. Available from: http://www.emro.who.int/emhj-volume-16-2010/volume-16-issue-1/article7.html
Duerink DO, Roeshadi D, Wahjono H, Lestari ES, Hadi U, Wille JC, et al. Surveillance of Healthcare-Associated Infections in Indonesian Hospitals. J Hosp Infect. 2006;62(2):219–29. https://doi.org/10.1016/j.jhin.2005.08.004
Zaidi AKM, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-Acquired Neonatal Infections in Developing Countries. Lancet. 2005;365(9465):1175–88. https://doi.org/10.1016/S0140-6736(05)71881-X
World Health Organization (WHO). WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care [Internet]. Vol. 30. 2009. 270 p. Available from: http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf doi: 10.1086/600379
Surya Pratama B, Koeswo M, Rokhmad K. Faktor Determinan Kepatuhan Pelaksanaan Hand Hygiene pada Perawat IGD RSUD dr. Iskak Tulungagung. J Kedokt Brawijaya [Internet]. 2015 Apr 1 [cited 2019 May 22];28(2):195–9. Available from: http://jkb.ub.ac.id/index.php/jkb/article/view/954 doi: 10.21776/ub.jkb.2015.028.02.14
World Health Organization. Hand Hygiene Technical Reference Manual. Geneva: WHO Press; 2009. 31 p.
Higgins RD, Baker CJ, Raju TNK. Executive Summary of the Workshop on Infection in the High-Risk Infant. J Perinatol [Internet]. 2010;30(6):379–83. Available from: http://dx.doi.org/10.1038/jp.2009.199 doi: 10.1038/jp.2009.199
Pessoa-silva CL, Hugonnet S, Pfister R, Touveneau S, Dharan S, Posfay-barbe K, et al. Reduction of Health Care – Associated Infection Risk in Neonates by Successful Hand Hygiene Promotion. 2007; https://doi.org/10.1542/peds.2006-3712
Raskind CH, Worley S, Vinski J, Goldfarb J. Hand Hygiene Compliance Rates After an Educational Intervention in a Neonatal Intensive Care Unit. Infect Control Hosp Epidemiol. 2007;28(09):1096–8. https://doi.org/10.1086/519933
Kowitt B, Jefferson J, Mermel LA. Factors Associated with Hand Hygiene Compliance at a Tertiary Care Teaching Hospital. Infect Control Hosp Epidemiol. 2013;3(11):1–7. https://doi.org/10.1086/673465
Moghnieh R, Soboh R, Abdallah D, El-Helou M, Al Hassan S, Ajjour L, et al. Health Care Workers' Compliance to the My 5 Moments for Hand Hygiene: Comparison of 2 Interventional Methods. Am J Infect Control [Internet]. 2017;45(1):89–91. Available from: http://dx.doi.org/10.1016/j.ajic.2016.08.012 doi: 10.1016/j.ajic.2016.08.012
Bahal A, Karamchandani D, AP F, ML M. Hand Hygiene Compliance : Universally better Post-Contact than Pre-Contact in Healthcare Workers in the UK and Australia. Br J Infect Control. 2007;8(1):24–8.
Wendt C, Knautz D, Baum H von. Differences in Hand Hygiene Behavior Related to the Contamination Risk of Healthcare Activities in Different Groups of Healthcare Workers. 2004;25(3):203–6.
Allegranzi B, Pittet D. Role of Hand Hygiene in Healthcare-Associated Infection Prevention. J Hosp Infect [Internet]. 2009;73(4):305–15. Available from: http://dx.doi.org/10.1016/j.jhin.2009.04.019 doi: 10.1016/j.jhin.2009.04.019
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