Evolution and associated factors of hand hygiene compliance in a pediatric tertiary hospital

• Published in: American journal of infection control 2020-11, Vol.48 (11), p.1305-1310
• Main Authors: Gras-Valentí, P., Mora-Muriel, J.G., Fuster-Pérez, M., Benito-Miralles, C.M., Vela-Morales, M.C., González-Hernández, M., Cabrera-Tejada, G.G., Esquembre-Menor, C., Sánchez-Payá, J.
• Format: Article
• Language: English
• Subjects: Child; Cross Infection; Cross-Sectional Studies; Guideline Adherence; Hand Hygiene; Health care associated infection; Health care workers; Humans; Infant, Newborn; Infection Control; patient safety; Tertiary Care Centers
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2020.05.013

•Compliance with recommendations on Hand Hygiene varies in the different areas.•Compliance with recommendations on Hand Hygiene can and should be improved.•One modifiable associated factor is the indications “after an activity has been performed.”•Other modifiable associated factors is the availability of pocket-size alcohol-based solution. The objective is to know the evolution of the Degree of Compliance with Recommendations (DCR) on hand hygiene (HH) and its associated factors in the pediatric care areas (PCAs) of a tertiary hospital. Observational, cross-sectional study, repeated over time, with direct observation of the DCR on HH during the daily activity of health care workers. Over 13 years, 9226 HH opportunities were observed. Associations between DCR, PCA and other variables (eg, age, sex, and professional position) were examined using χ² and adjusted odds ratios (aOR) with 95% confidence intervals (CI). DCR on HH in 9 PCAs was 64.3% (95% CI, 63.3-65.3), and in the group of non-pediatric areas it was 49.6% (95% CI, 49.1-50.1). The areas with the highest degree of compliance were Oncology 72.8% (95% CI, 69.2-76.4), Neonatology 73.2% (95% CI, 71.3-75.1), and Neonatal intensive care unit 70.0% (95% CI, 67.5-72.6). These were the areas with the strongest association with HH compliance, with aOR:2.8 (95% CI, 2.2-3.6); aOR, 3.0 (95% CI, 2.6-3.6) aOR:2.6 (95% CI, 2.1-3.1), respectively. Other associated factors were the indications “after an activity,” aOR, 1.6 (95% CI, 1.5-1.8) and the availability of pocket-size alcohol-based solution, aOR, 2.1(95% CI, 1.9-2.3). The DCR on HH in PCAs is higher than in other areas, although there is still margin for improvement. We have identified modifiable factors that have an independent association with HH compliance in PCAs. Focusing on modifiable factors will increase compliance with HH with the ultimate goal of reducing healthcare associated infections.