Nai-Chung Nelson Chang1,2,3, Heather Schacht Reisinger4,5, Marin L Schweizer4,5, Ichael Jones6, Elizabeth Chrischilles1, Margaret Chorazy1, Charles Huskins7, Loreen Herwaldt1,5. 1. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA. 2. Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA. 3. Veterans Affair Salt Lake City Health Care System, Salt Lake City, Utah, USA. 4. Iowa City Veterans Affair Health Care System, Iowa City, Iowa, USA. 5. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. 6. Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA. 7. Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
Abstract
BACKGROUND: Most articles on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers (HCWs) are noncompliant. We assessed how task type affected HCWs' hand hygiene compliance. METHODS: We linked consecutive tasks individual HCWs performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study into care sequences and identified task pairs-2 consecutive tasks and the intervening hand hygiene opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, HCW type, and compliance at prior opportunities. RESULTS: Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR], 0.97 [95% confidence interval {CI}, .95-.98]) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR, 1.12 [95% CI, 1.10-1.13]). Nurses were more likely to perform both critical and contaminating tasks, but nurses' hand hygiene compliance was better than physicians' (aOR, 0.94 [95% CI, .91-.97]) and other HCWs' compliance (aOR, 0.87 [95% CI, .87-.94]). CONCLUSIONS: Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.
BACKGROUND: Most articles on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers (HCWs) are noncompliant. We assessed how task type affected HCWs' hand hygiene compliance. METHODS: We linked consecutive tasks individual HCWs performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study into care sequences and identified task pairs-2 consecutive tasks and the intervening hand hygiene opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, HCW type, and compliance at prior opportunities. RESULTS: Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR], 0.97 [95% confidence interval {CI}, .95-.98]) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR, 1.12 [95% CI, 1.10-1.13]). Nurses were more likely to perform both critical and contaminating tasks, but nurses' hand hygiene compliance was better than physicians' (aOR, 0.94 [95% CI, .91-.97]) and other HCWs' compliance (aOR, 0.87 [95% CI, .87-.94]). CONCLUSIONS: Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.
Authors: Victoria Williams; Adam Kovacs-Litman; Matthew P Muller; Susy Hota; Jeff E Powis; Daniel R Ricciuto; Dominik Mertz; Kevin Katz; Lucas Castellani; Alex Kiss; Amber Linkenheld-Struk; Jerome A Leis Journal: CMAJ Open Date: 2021-12-14
Authors: Nai-Chung N Chang; Marin L Schweizer; Heather Schacht Reisinger; Michael Jones; Elizabeth Chrischilles; Margaret Chorazy; W Charles Huskins; Loreen Herwaldt Journal: Infect Control Hosp Epidemiol Date: 2021-05-14 Impact factor: 6.520