1003. Hand hygiene surveillance in OR in Turku University Hospital in Finland
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
  • Terho.pdf (949.7 kB)
  • Background: Surgical hand preparation (SHP) has been recommended for a long as a measure to reduce infection resulting from surgery. In Finnish health care system surgical hand antisepsis using an alcohol-based hand rub is recommended based on better compliance and dermal tolerance. Adherence to recommended measures is lacking. First surveillance was made by year 2004, when 98 % (n=106) of HCW made surgical hand preparation by using soap and water.The aim of this study is developing and evaluating a strategy for SHP guideline implementation. The aim of an observation was surgical hand antisepsis using alcohol-based hand rub, including technical aspects, required time and drying time. Primary objective was to increase surgical hand preparation using alcohol-based hand rub.

    Methods: Infection control nurses educated HCW to SHP protocol. The user is then requested to perform SHP with an AHR (ethanol) that cover hands and forearms as well as the elbows (a total of 15 ml of AHR) and to continue rubbing until the hands are dry. This requires a surgical scrub of 3-minutes duration. An educational video was made. ICN were enrolled to OR to directly collect data. Structured observation and survey was designed to collect data.

    Results: Hand rub practices of 180 male and 176 female HCWs were evaluated by ICN. Total 356 surgical hand preparation procedures were studied. There was no observed use of rings or jewellery. Procedure length and accuracy were acceptable in 2.0 % (n=7). Nurses performed surgical hand preparation better than surgeons. Average time for surgical hand preparation using hand rub was 2 minutes 34 seconds (0– 8 min 15 s).  Average time for SHP with medicated soap and water and with AHR was 4 min 5 s (35 s–9min 56s). 73% (260) continued AHR until the hands were dry.

    Conclusion: Results confirm that recommended hand hygiene practices before surgery remain low. Lack of knowledge of guidelines and protocols seem to be reality. There was also scepticism about the effectiveness of alcohol based hand rubs. One education session is not enough to improve surgical team’s compliance. We believe that the hand-rubbing protocol for pre-surgical hand disinfection should be considered as a time saving issue, when compliance of AHR protocol is increasing.

    Tiina Kurvinen, masterdegree, Infection control, Turku university hospital, Turku, Finland, Kirsi Terho, masterdegree, Infection control, Turku University hospital, Turku, Finland and Infection Control Department of Hospital District of Southwest Finland


    T. Kurvinen, None

    K. Terho, None

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