World Health Organization Hand Hygiene Compliance Self-Assessment and Microbiological Hand Contamination Among Healthcare Workers in Mwanza Region. Tanzania
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TextPublisher number: Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz:www.bugando.ac.tzLanguage: English Publication details: Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2020Description: xiii; 98 Pages; Includes References and AppendicesSubject(s): Summary:
Abstract:
Background: Hand hygiene (HH) practices recommended by the World Health Organization (WHO) are pivotal cost-effective measures to prevent health care associated infections (HCAI), but compliance remained to be a major challenge. We compared the self-reported HH compliance among health care workers (HCWs) using a WHO tool across healthcare facilities (HCF), and microbiological assessment of hand contamination so as to guide specific infection prevention and control (IPC) measures.
Methodology: A cross-sectional analytical study was conducted between July and September 2019 involving 18 HCF in Mwanza region. HH was assessed using the WHO Hand Hygiene Self-Assessment Framework (2010) in the six priority units. A total of 212 HCWs’ hands were sampled for microbiological analysis to identify Gram negative faecal coliforms and Methicillin resistant Staphylococcus aureus. Self-reported HH compliance was compared with the microbiological hand contamination, and associated factors determined.
Results: The median HH score (IQR) was 212.5 (190-245) i.e. basic level. The scores were progressively increasing from health centers 190(175-215) (basic level), district hospital 215(205-240) (basic level), regional referral hospital 275(275-287.5) (intermediate level), and tertiary hospital 320(315-325) (intermediate level) A total of 203 (95.8%) self-reported to have washed their hands. Self-reported HH compliance using cut-off value of ≥51.0% and the WHO recommended cut-off value of ≥81.0% were 39.2% (29/74) and 10.8% (8/74), respectively. Of the 212 HCW, 56 (26.4%) had bacteria contamination; 17.9% (n=38) by Gram negative fecal coliforms, 8.0% (n=17) by MRSA and 0.5% (n=1) by both. Hand contamination was significantly higher in district hospitals (pvalue=0.0437) compared to other HCF; and among HCW residing in the rural areas (27.5%), pvalue=0.017.
Conclusion: The median HH score amongst HCF in Mwanza region was at basic level, and was increasing from lower to higher rank of HCF. A quarter of HCW’s hands were contaminated and this was not matching with the self-reported HH assessment tools. A need to incorporate HH microbiological parameters to the WHO HH assessment tool is needed. Future IPC interventional measures should be tailored to the HCF tiers and rural areas.
| Item type | Current library | Collection | Status | Barcode | |
|---|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | NFIC | 1 | PD0373 |
Abstract:
Background: Hand hygiene (HH) practices recommended by the World Health Organization (WHO) are pivotal cost-effective measures to prevent health care associated infections (HCAI), but compliance remained to be a major challenge. We compared the self-reported HH compliance among health care workers (HCWs) using a WHO tool across healthcare facilities (HCF), and microbiological assessment of hand contamination so as to guide specific infection prevention and control (IPC) measures.
Methodology: A cross-sectional analytical study was conducted between July and September 2019 involving 18 HCF in Mwanza region. HH was assessed using the WHO Hand Hygiene Self-Assessment Framework (2010) in the six priority units. A total of 212 HCWs’ hands were sampled for microbiological analysis to identify Gram negative faecal coliforms and Methicillin resistant Staphylococcus aureus. Self-reported HH compliance was compared with the microbiological hand contamination, and associated factors determined.
Results: The median HH score (IQR) was 212.5 (190-245) i.e. basic level. The scores were progressively increasing from health centers 190(175-215) (basic level), district hospital 215(205-240) (basic level), regional referral hospital 275(275-287.5) (intermediate level), and tertiary hospital 320(315-325) (intermediate level) A total of 203 (95.8%) self-reported to have washed their hands. Self-reported HH compliance using cut-off value of ≥51.0% and the WHO recommended cut-off value of ≥81.0% were 39.2% (29/74) and 10.8% (8/74), respectively. Of the 212 HCW, 56 (26.4%) had bacteria contamination; 17.9% (n=38) by Gram negative fecal coliforms, 8.0% (n=17) by MRSA and 0.5% (n=1) by both. Hand contamination was significantly higher in district hospitals (pvalue=0.0437) compared to other HCF; and among HCW residing in the rural areas (27.5%), pvalue=0.017.
Conclusion: The median HH score amongst HCF in Mwanza region was at basic level, and was increasing from lower to higher rank of HCF. A quarter of HCW’s hands were contaminated and this was not matching with the self-reported HH assessment tools. A need to incorporate HH microbiological parameters to the WHO HH assessment tool is needed. Future IPC interventional measures should be tailored to the HCF tiers and rural areas.
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