Program Schedule

1518
Hand Hygiene for Patients: an Initiative to Study and Promote Hand Hygiene Practice for Hospitalized Patients

Session: Poster Abstract Session: Hand Hygiene
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • ID Week Patient Hand Hygiene Poster 9.2.14 Final.pdf (491.2 kB)
  • Background:    Hand hygiene (HH) practice in hospitalized patients has not been widely studied.  Patient HH (PHH) may affect the acquisition of hospital acquired infections (HAIs) by direct contact transmission.  The healthcare worker (HCW) is the primary resource for PHH assistance and education. The acuity and mobility status of patients may be obstacles to HH.  Preliminary surveys at our hospital showed HH education was provided 20% of the time and HH opportunities before meals and after toileting occurred ˂ 50% of the time.  A PHH study was implemented on 4 patient units to provide education coupled with pre-packaged alcohol wipes (AWs) at the bedside to improve PHH practice.  

    Methods:  Patients were surveyed over a 1 month period concerning their HH practices for baseline data.  HCWs were then in-serviced on the value of PHH and requested to educate all new patients.  AWs (Sani Hands® 69.5% alcohol) were made available. Daily reminders and assisted opportunities for HH were encouraged.  Dietary provided a reminder on meal trays for HH prior to eating.  After implementation, follow-up surveys were collected for a 4 month period.  Percent improvement was analyzed by Chi-square test. HAIs were followed pre- and post-intervention.

    Results:  PHH increased significantly post-intervention (see Table 1).  C. difficile infections (CDIs) decreased (14 pre- and 9 post-intervention) with no reduction noted in other HAIs during the study.

    Conclusion:  PHH practice can be improved by providing education, the opportunity to clean hands with AWs and encouragement.  Incidence of CDI may be influenced by improved PHH practice.

    Table 1. Patient HH Survey  Questions               

    Pre-intervention (N=97)

    Post-intervention  (N=291)

    Percentage Change

      Chi-Square       p-value

    Verbal or written education provided  

    33/96 (34%)

    188/291 (64%)

    88.20%

    <0.0001

    Opportunity for HH  provided  

    55/92 (60%)

    251/291 (86%)

    43.30%

    <0.0001

    Encouragement for HH:

    Prior to meals

    51/92 (55%)

    201/277 (72.5%)

    31.80%

    0.002

    After toileting

    66/94 (70%)

    236/287 (82%)

    17.10%

    0.013

    Before or after having visitors

    21/87 (24% )

    106/253 (41.8%)

    74.20%

    0.003

    Before touching dressings or incisions

    15/73 (20.5%)

    92/194 (47.4%)

    131.20%

    <0.0001

    After returning from testing or procedure 

    18/76 (23.6%)

    88/214 (41%)

    73.70%

    0.007

     

    Marian Pokrywka, MS, CIC, Infection Control, UPMC Mercy Hospital, Pittsburgh, PA, Margaret Dicuccio, MSN, RN, Nursing, UPMC Mercy Hospital, Pittsburgh, PA, Heather Dixon, MSN, RN, Quality, UPMC Mercy Hospital, Pittsburgh, PA; UPMC Mercy Hospital, Pittsburgh, PA, Thomas Hritz, PhD, RD, LDN, Nutrition, UPMC Mercy Hospital, Pittsburgh, PA and Mohamed Yassin, MD, PhD, Medicine, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA

    Disclosures:

    M. Pokrywka, None

    M. Dicuccio, None

    H. Dixon, None

    T. Hritz, None

    M. Yassin, None

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