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Hand Hygiene Compliance among PGH

health-care workers at the Medicine wards
and ICU
Submitted by Acta [1] on Tue, 03/12/2013 - 3:36am
Anna Flor A. Gaboy

ABSTRACT
Background: Hand hygiene prevents health-care associated infections, consequently
reducing mortality, hospital costs and emergence of multidrug resistance organisms.
Objectives: To determine hand hygiene compliance and identify factors contributing to
compliance and noncompliance among PGH health care workers in the Medicine wards and
ICU through direct observation, infrastructure survey, and written survey
Design: Cross-sectional survey of practices, resources, knowledge, attitudes and perceptions
towards hand hygiene.
Setting: University of the Philippines - Philippine General Hospital, Medicine wards and
Intensive care unit.
Methods: Hand hygiene compliance among doctors, nurses and students were monitored
during routine patient care. Opportunities for hand hygiene were identified whenever an
indication exists, as specified by the WHO five moments of hand hygiene. The availability and
accessibility of sinks and hand hygiene products, as well as visibility of posters promoting
hand hygiene were assessed. Thereafter, a survey was conducted to assess the knowledge,
attitudes and perceptions of health care workers toward hand hygiene.
Results: Overall hand hygiene compliance was 10.6%. Factors associated with
noncompliance include: doctor status, ward location, and requirement of hand hygiene before
patient contact. On the other hand, nurse status, ICU location, requirement of hand hygiene
before aseptic procedure, after exposure to body fluid and after patient contact predicted
compliance. Sinks, hand hygiene products and posters on hand hygiene were insufficient and
inaccessible. Majority have fair knowledge and positive attitude toward hand hygiene, while
perceptions were

overestimated.
Conclusion: Hand hygiene compliance was unacceptably low despite years of hand hygiene
campaign. The main problem for non-compliance is the lack of sinks, hand hygiene products
and hand hygiene reminders in the workplace. The high demand for hand hygiene
recommends handrubbing with alcohol based solution for routine hand antisepsis over timeconsuming handwashing unless indicated. Compliance was strongly associated with
professional status, hospital location and hand hygiene indication. Knowledge, attitudes and
perceptions seem to play a minor role in the overall hand hygiene performance of health care
workers.

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