Researchers Test Implementation of WHO Hand Hygiene Improvement Strategy in Critical Care Units

To determine hand hygiene compliance before and after an intervention campaign in critical care units, Mazi, et al. (2013) conducted their study in the intensive care unit (ICU), neonatal intensive care unit (NICU), burn unit (BU) and the kidney unit of the King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia.

 The observation using the WHO hand hygiene protocol took place in four phases with phase I, between April 24, 2010 through May 6, 2010 and phase II from May 29, 2010 and June 9, 2010. An educational intervention took place between the Phases I and II. Follow-up Phases III and IV were from Oct. 1-15, 2010 and March 15-30, 2011 respectively.
The researchers found 1,975 hand hygiene opportunities comprising of 409 in Phase I, 406 in Phase II, 620 in Phase III and 540 Phase IV were observed. Compliance rate was 67 percent pre-intervention, 81 percent in phase II, declining to 59 percent and 65 percent in phases III and IV. Increased compliance in the ICU from 39 percent in Phase I to 81 percent in Phase IV (p < 0.05) was sustained throughout the study.

Highest compliance rates were recorded among nurses in all phases. The improved compliance for physicians observed in the post-intervention phase was lost in follow-up phases. Missed opportunities for hand hygiene were before patient contact, after touching patient's surrounding and before aseptic techniques. Team-work and leadership were identified as enhancing factors for compliance.
The researchers conclude that the WHO hand hygiene strategy combined with health education, continuous evaluation and team approach resulted in increased compliance but this was not sustained in certain critical care areas. Their research was published in Antimicrobial Resistance and Infection Control.

Reference: Mazi W, Senok AC, Al-Kahldy S and Abdullah D. Implementation of the World Health Organization hand hygiene improvement strategy in critical care units. Antimicrobial Resistance and Infection Control 2013, 2:15 doi:10.1186/2047-2994-2-15