Study of hand hygiene opportunities and compliance

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Nurses have 3 times more HHOs than physicians, yet nurses have 1.5 times higher compliance than physicians” Azim et al (2016).

Abstract:

Background: To understand whether the burden of hand hygiene contributes to poor compliance we measured the daily number of hand hygiene opportunities (HHOs) by shift for nurses and physicians in 2 wards in a 850-bed university teaching hospital.

Methods: On each ward 4 trained auditors collected the number of HHOs and compliance events for 24 hours over 7 days. Twenty-one thousand four hundred fifty HHOs were collected from a medical and a surgical ward. The proportion of alcohol-based handrub used daily, the burden of hand hygiene, and compliance rates were calculated separately for nurses and physicians.

Results: The average indication for alcohol-based handrub cleansing represented 68% of all HHOs. Nurses had an average burden of 55 HHOs per 24 hours or 27 HHOs per shift, 3 times higher than the burden for physicians, who had 16 HHOs per 24 hours or 8 HHOs per shift. Overt observations of the weekly compliance identified nurses had 1.5 times higher compliance than physicians: 76% and 52% (P < .01), respectively.

Conclusions: Nurses have 3 times more HHOs than physicians, yet nurses have 1.5 times higher compliance than physicians. Hand hygiene compliance in physicians cannot be explained by burden of HHOs.

Reference:

Azim, S., Juergens, C., and McLaws, M-L. (2016) An average hand hygiene day for nurses and physicians: The burden is not equal. American Journal of Infection Control. March 31st. [epub ahead of print].

DOI: http://dx.doi.org/10.1016/j.ajic.2016.02.006

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