Hand hygiene is considered to be the single most effective measure against the spread of healthcare-associated infection, but studies have reported poor hand hygiene compliance among healthcare workers during interaction with patients, contributing to the spread of disease. Numerous interventions have aimed to improve the hand hygiene practices of healthcare workers in healthcare settings, however little attention has been paid to patients and their visitors hand hygiene. Lary et al. (2013) sought to measure hand hygiene opportunities taken by healthcare workers (HCWs), patients and visitors to gain a picture of their hand hygiene compliance and to examine whether hands of HCWs, patients, visitors and surfaces near touch sites act as a reservoir for MRSA.
Observation of HCWs, patients and visitors hand hygiene compliance was measured over period of 10 weeks across six ediatric wards in a teaching hospital. Additionally, swabs were taken from subjects hands and surfaces and samples were idntified using molecular identification techniques. Antibiotic susceptibility profiling was applied on S. aureus isolates to detect the presence of MRSA.
A total of 1,891 hand hygiene opportunities observed consisting of 1,366 for HCWs, 525 for patients and visitors. Among HCWs, doctors showing the highest level of complaince compared to other professions (P<0.001). There was no difference in compliance between patients and visitors (P=0.53). A total of 105 samples were obtained from hand and 92 from surfaces. MRSA was observed in 5 percent of hands and environmental samples. Moreover, samples collected on the same day, from different hands and surfaces had similar microbial fingerprints and patterns of antibiotic sensitivity.
The researchers concluded that the levels of HCWs' hand hygiene compliance found in this study were better than the previously reported. The researchers say they were unable to draw conclusions about patients hand hygiene compliance due to the nature of the clinical environment; however, visitors' compliance was considered to be higher than previous reported studies. Furthermore, hand and surfaces may act as reservoir for MRSA, increasing the risk of HAI.
Reference: D Lary, K Hardie, J Randle and A Clavert. Poster presentation P120 the 2nd International Conference on Prevention and Infection Control (ICPIC 2013): Monitoring hand hygiene compliance and the distribution of MRSA in paediatric wards. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P120 doi:10.1186/2047-2994-2-S1-P120