Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study.

Autor: Onyedibe KI; Department of Medical Microbiology, University of Jos, Jos, Nigeria. kenonyedibe@yahoo.com., Shehu NY; Infectious Diseases Unit, Department of Medicine, University of Jos, Jos, Nigeria., Pires D; Infection Control Programme and WHO Collaborating Centre on Patient Safety - Infection Control & Improving Practices, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.; Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal., Isa SE; Infectious Diseases Unit, Department of Medicine, University of Jos, Jos, Nigeria., Okolo MO; Department of Medical Microbiology, University of Jos, Jos, Nigeria., Gomerep SS; Infectious Diseases Unit, Department of Medicine, University of Jos, Jos, Nigeria., Ibrahim C; Department of Nursing Services, Jos University Teaching Hospital, Jos, Nigeria., Igbanugo SJ; Department of Pharmacy, Jos University Teaching Hospital, Jos, Nigeria., Odesanya RU; Department of Pharmacy, Jos University Teaching Hospital, Jos, Nigeria., Olayinka A; Department of Medical Microbiology, Ahmadu Bello University, Zaria, Nigeria., Egah DZ; Department of Medical Microbiology, University of Jos, Jos, Nigeria., Pittet D; Infection Control Programme and WHO Collaborating Centre on Patient Safety - Infection Control & Improving Practices, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland. Didier.Pittet@hcuge.ch.
Jazyk: angličtina
Zdroj: Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2020 Feb 11; Vol. 9 (1), pp. 30. Date of Electronic Publication: 2020 Feb 11.
DOI: 10.1186/s13756-020-0693-1
Abstrakt: Background: The burden of healthcare-associated infection (HAI) is 2 to 18 times higher in developing countries. However, few data are available regarding infection prevention and control (IPC) process indicators in these countries. We evaluated hand hygiene (HH) facilities and compliance amongst healthcare workers (HCW) in a 600-bed healthcare facility in Northcentral Nigeria providing tertiary care service for a catchment population of about 20 million.
Methods: An in-house facility assessment tool and the World Health Organization (WHO) direct observation method were used to assess the HH facilities and compliance, respectively. Factors associated with good compliance were determined by multivariate analysis.
Results: The facility survey was carried out in all 46 clinical units of the hospital. 72% of the units had no poster or written policy on HH; 87% did not have alcohol-based hand rubs; 98% had at least one handwash sink; 28% had flowing tap water all day while 72% utilized cup and bucket; and 58% had no hand drying facilities. A total of 406 HH opportunities were observed among 175 HCWs. The overall compliance was 31%, ranging from 18% among ward attendants to 82% among medical students. Based on WHO "5 moments" for HH, average compliance was 21% before patient contact, 23% before aseptic procedure, 63% after body fluid exposure risk, 41% after patient contact and 40% after contact with patients' surrounding. Being a medical student was independently associated with high HH compliance, adjusted odds ratio: 13.87 (1.70-112.88).
Conclusions: Availability of HH facilities and HCW compliance in a large tertiary hospital in Nigeria is poor. Our findings confirm that HCWs seem more sensitized to their risk of exposure to potential pathogens than to the prevention of HAI cross-transmission. Inadequate HH facilities probably contributed to the poor compliance. Specific measures such as improved facilities, training and monitoring are needed to improve HH compliance.
Databáze: MEDLINE
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