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

Sánchez Payá J, Hernández García I, Camargo Ángeles R, Villanueva Ruiz CO, Martín Ruiz AC, Román F, García Shimizu P, Llorens P

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.

Camargo Ángeles R, García Shimizu P, Hernández-García I, Llorens P, Martín Ruiz AC, Román F, Sánchez-Payá J, Villanueva Ruiz CO