Anaya-Flores VE, Ortiz-López S, Hernández-Zárate VE, García-Hernández A, Jiménez-Bravo ML, Ángeles-Garay U

Language: Spanish
References: 22
Page: 141-146
PDF size: 101.96 Kb.

ABSTRACT

Introduction: Hand washing (HW) is the main strategy to prevent nosocomial infections (Nis). Washing the hands for 30 seconds reduces up to 90% of bacteria on hands.
Objective: To determine the prevalence of HW and associated factors to unaccomplishment in Hospital of Specialties at National Medical Center "La Raza".
Methodology: Doctors, nurses, and respiratory therapists were randomized selected, observed, and interviewed by trained nurses utilizing the "Guideline for HW in Hospitals" to evaluate the adequate accomplishment of HW. Through a questionnaire, factors associated to unaccomplishment of HW, existence of supplies for HW, knowledge regarding prevention of INs, and periodicity of HW training were researched. Analysis of simple frequencies, Ji square, t-student, and variability analysis were performed.
Results: 299 health workers were interviewed. The general prevalence of HW was 60.2%. Nurses 62%, resident doctors 57.6%, doctors 75%, and respiratory therapists 20% (p=0.03). 56.5% respondents manifested having received a lecture about HW; 41.1% needs training. The motive of unaccomplishment of HW was 28.4% due to overwork; 31.8 due to lack of supplies; and 9.6% due to skin irritation. Factors associated to unaccomplishment were lack of disposable paper towels, and unknowing the existence of a INs Committee (p‹0.01).
Conclusions: The prevalence of HW in the hospital is acceptable; however, the quality of HW is poor. The lack of supplies for HW, and unknowing the existence of Infections Committee is associated to unaccomplishment of HW.

REFERENCES

1. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000; 356(9238): 1307-12.

2. Conly JM, Hill S, Ross J, Lertzman J, Louie TJ. Handwashing practices in an intensive care unit: the effects of an educational program and its relationship to infection rates. Am J Infect Control 1989; 17(6):330-9.

3. Herruzo-Cabrera R, Vizcaino-Alcaide MJ, Fernández-Aciñero MJ. Usefulness of an alcohol solution of N-duopropenide for the surgical antisepsis of the hands compared with handwashing with iodine-povidone and chlorhexidine: clinical essay. J Surg Res 2000; 94(1):6-12.

4. Montville R, Chen Y, Schaffner DW. Risk assessment of hand washing efficacy using literature and experimental data. Int J Food Microbiol 2002; 73(2-3): 305-13.

5. Kampf G, Ostermeyer C. Intra-laboratory reproducibility of the hand hygiene reference procedures of EN 1499 (hygienic handwash) and EN 1500 (hygienic hand disinfection). J Hosp Infect 2002; 52(3):219-24.

6. Kampf G, Ostermeyer C. Inter-laboratory reproducibility of the hand disinfection reference procedure of EN 1500. J Hosp Infect 2003; 53(4):304-6.

7. Stein AD, Makarawo TP, Ahmad MF. A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. J Hosp Infect 2003; 54(1):68-73.

8. Harris AD, Samore MH, Nafziger R, DiRosario K, Roghmann MC, Carmeli Y. A survey on handwashing practices and opinions of healthcare workers. J Hosp Infect 2000; 45(4):318-21.

9. Garavaglia MT, Bassoli L, Cappoia S, Medaglia M, Meroni C, Morgutti M, et al. "Mani pulite" in terapia intensive. Minerva Anestesiol 2004; 70(5):425-30.

10. Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004; 17(4):863-93.

11. Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee. HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 2002; 51(RR-16):1-45.

12. Pittet D. Hand hygiene: improved standards and practice for hospital care. Curr Opin Infect Dis 2003; 16(4):327-35.

13. Pittet D. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 2001; 7(2): 234-40.

14. Pittet D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000; 21(6):381-86.

15. Gastmeier P. Nosocomial infection surveillance and control policies. Curr Opin Infect Dis 2004; 17(4):295-301.

16. Boyce JM. It is time for action: improving hand hygiene in hospitals. Ann Intern Med 1999; 130(2):153-5.

17. Larson E, Killien M. Factors influencing handwashing behavior of patient care personnel. Am J Infect Control 1982; 10(3):93-9.

18. Jacobson G, Thiele JE, McCune JH, Farrell LD. Handwashing: ring-wearing and number of microorganisms. Nurs Res 1985; 34(3):186-8.

19. Hoffman PN, Cooke EM, McCarville MR, Emmerson AM. Micro-organisms isolated from skin under wedding rings worn by hospital staff. Br Med J 1985; 290(6463):206-7.

20. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20(4): 250-78.

21. Secretaría de Salud. PROYECTO de Norma Oficial Mexicana PROY-NOM-045-SSA2-2005, Para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales. Diario Oficial de la Federación 7 de agosto de 2006.

22. Instituto Mexicano del Seguro Social. Dirección de Prestaciones Médicas. Norma que establece las disposiciones para la vigilancia prevención y control de las infecciones nosocomiales en las unidades médicas de segundo y tercer nivel de atención del Instituto Mexicano del Seguro Social. Octubre de 2006.