Padmini Murthy, MD, Preventive Medicine, 07:55AM Aug 30, 2013
I hope all of you enjoyed the summer. I had a busy summer and travelled overseas to South Korea and Taiwan. What struck me the most was apart form the tremendous technological strides in the country was the obvious use of use face masks and hand sanitizers by people I saw in most public areas. Last week there was an interesting article published in The Lancet about the importance of improving hand hygiene for health care workers. The World health organization has been at the fore front of improving and stressing the importance of hand hygiene for health care workers globally as iatrogenic or health care related spread of infections is a major public health challenge. In a 2 year multi country study conducted to implement the WHO’s recommended strategy for improved compliance in hand hygiene among health workers demonstrated an increase from 51% (pre implementation) to 67 %( post implementation) . This impact was more in low and mid income countries when compared to high income countries, according to Dr. Benedetta Allegranzi, Program Manager, Clean Care is Safer Care, WHO Patient Safety Program ,who further added that the evidence gathered reiterated the importance of improving hand hygiene in promoting safety for patients. The strategy outlined below for promoting hand hygiene by the WHO was simple and highly effective
1. Important to ensure that the health care workers had access to alcohol based hand cleaners at every point of patient care.
2. Targeted training and education of health care workers as to when they need to ensure hand hygiene is practiced during patient care.
3. Monitoring and reported feedback on compliance by the care givers.
4. Placement of visual reminders of the importance and necessity for hand hygiene at various points in the work place.
5. WHO also strongly reiterated the importance of the creation of a culture of attention to patient and health-care worker safety within the institution. (Source: WHO, 2013)
In addition The WHOs recommendations for the timing and frequency of hygiene compliance (using alcohol based rub or soap and water) are as follows:
1.” Before touching a patient;
2. Before clean and aseptic procedures (e.g., inserting devices such as catheters);
3. After contact with body fluids;
4. After touching a patient;
5. After touching patient surroundings” (Source : WHO, 2013)
23 August 2013 | Geneva - WHO’s strategy for improving hand hygiene is easy for health-care workers to practise, according to a new study published today in "Lancet Infectious Diseases". Health care-associated infections are a major threat to patient safety worldwide and transmission in these settings is mainly from the hands of health-care workers.
Strategy shown to increase hand hygiene compliance
In six sites in Costa Rica, Italy, Mali, Pakistan and the Kingdom of Saudi Arabia, the research team implemented WHO’s strategy in 55 departments in 43 hospitals. During the two-year period between December 2006 and December 2008, compliance with best practices increased from 51% before the study to 67% and infrastructures and staff knowledge were also significantly improved in all sites. The study also demonstrated that this change in practices and safety culture was sustained up until at least two years since the conclusion of the testing phase.
“The WHO strategy was based on a multimodal approach previously proven to have a dramatic effect in reducing the number of health-care related infections at the WHO Collaborating Centre on Patient Safety at the University of Geneva Hospitals, but now for the first time we have evidence of its feasibility and successful effect to improve hand hygiene in a variety of different geographical and income settings, with even greater impact in low-income and middle-income countries than in high-income countries,” said Dr Benedetta Allegranzi, Programme Manager, Clean Care is Safer Care, WHO Patient Safety Programme and lead author of the paper.
Hand contact the leading cause of infections
This WHO recommended strategy at present has been widely implemented globally in more than 15,700 health-care settings in 168 countries In addition 50 governments have based their national hand hygiene campaigns on it. This practice is considered as a universal gold standard of patient care.
In conclusion hand the practice of improved hand hygiene is a highly effective tool in primary and secondary prevention and reduction of infectious, so let us remember to carry our hand sanitizers with us as the upcoming flu season approaches.
Till my next post in September,