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      Action research on promoting hand hygiene practices in an intensive care unit

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          Abstract

          Aim

          Evaluate the intensive care acquired infections incidence and the change over time in infection practices in one intensive care unit.

          Design

          We used an action research approach with cyclical activities.

          Methods

          Our study included two cycles with hand hygiene observation based on the WHO's five‐moments observation tool, observing hand hygiene practices, analysing the observations, and giving feedback on observations, intensive care acquired infection rates, and alcohol‐based hand rub consumption. The Revised Standards for Quality Improvement Reporting Excellence is the basis for this research report describing research aimed at improving patient safety and quality of care.

          Results

          During the study, annual alcohol‐based hand rub consumption increased by 6.7 litres per 1000 patient days and observed hand hygiene compliance improved. In the first cycle of the study, there was a decrease in critical care acquired infection rates, but the improvement was not sustainable.

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          Most cited references51

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          Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020

          Zhen-Dong Guo, Zhong-Yi Wang, Shou-Feng Zhang … (2020)
          To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m from patients.
          Article 0 comments Cited 491 times – based on 0 reviews     Review now
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            Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China

            Li Ran, Xuyu Chen, Ying Wang … (2020)
            Abstract Corona Virus Disease 2019 (COVID-19) originated in Wuhan, China has caused many healthcare workers (HCWs) infected. Seventy-two HCWs manifested with acute respiratory illness were retrospectively enrolled to analyze the risk factors. The high-risk department, longer duty hours, and suboptimal hand hygiene after contacting with patients were linked to COVID-19.
            Article 0 comments Cited 296 times – based on 0 reviews     Review now
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              Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.

              Craig A Umscheid, Matthew D. Mitchell, Jalpa Doshi … (2011)
              To estimate the proportion of healthcare-associated infections (HAIs) in US hospitals that are "reasonably preventable," along with their related mortality and costs. To estimate preventability of catheter-associated bloodstream infections (CABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP), we used a federally sponsored systematic review of interventions to reduce HAIs. Ranges of preventability included the lowest and highest risk reductions reported by US studies of "moderate" to "good" quality published in the last 10 years. We used the most recently published national data to determine the annual incidence of HAIs and associated mortality. To estimate incremental cost of HAIs, we performed a systematic review, which included costs from studies in general US patient populations. To calculate ranges for the annual number of preventable infections and deaths and annual costs, we multiplied our infection, mortality, and cost figures with our ranges of preventability for each HAI. As many as 65%-70% of cases of CABSI and CAUTI and 55% of cases of VAP and SSI may be preventable with current evidence-based strategies. CAUTI may be the most preventable HAI. CABSI has the highest number of preventable deaths, followed by VAP. CABSI also has the highest cost impact; costs due to preventable cases of VAP, CAUTI, and SSI are likely less. Our findings suggest that 100% prevention of HAIs may not be attainable with current evidence-based prevention strategies; however, comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.
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                Author and article information

                Contributors
                Kirsi Terho:
                ORCID: https://orcid.org/0000-0002-1816-085X
                kirsi.m.terho@gmail.com
                Journal
                Journal ID (nlm-ta): Nurs Open
                Journal ID (iso-abbrev): Nurs Open
                Journal ID (doi): 10.1002/(ISSN)2054-1058
                Journal ID (publisher-id): NOP2
                Title: Nursing Open
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2054-1058
                Publication date (Electronic): 03 January 2023
                Publication date Collection: May 2023
                Volume: 10
                Issue: 5 ( doiID: 10.1002/nop2.v10.5 )
                Pages: 3367-3377
                Affiliations
                [ 1 ] Department of Nursing Science University of Turku Turku Finland
                [ 2 ] Department of Hospital Hygiene and Infection control Turku University Hospital Turku Finland
                [ 3 ] Turku School of Economics Turku Finland
                [ 4 ] Turku University Hospital, Administration, Nursing Turku Finland
                Author notes
                [*] [* ] Correspondence

                Kirsi Terho, Department of Nursing Science, University of Turku, Turku, Finland.

                Email: kirsi.m.terho@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-1816-085X
                Article
                Publisher ID: NOP21591 Other ID: NOP-2022-Mar-0486.R2
                DOI: 10.1002/nop2.1591
                PMC ID: 10077419
                PubMed ID: 36594651
                SO-VID: 3529c1b3-32bc-42b0-95a9-f149466e32fc
                Copyright © © 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date revision received : 06 December 2022
                Date received : 25 March 2022
                Date accepted : 18 December 2022
                Page count
                Figures: 3, Tables: 3, Pages: 11, Words: 7514
                Funding
                Funded by: Finnish State Research grant
                Funded by: Päivikki ja Sakari Sohlbergin Säätiö , doi 10.13039/501100004212;
                Funded by: Sairaanhoitajien koulutussäätiö , doi 10.13039/501100020271;
                Funded by: The Finnish Cultural Foundation
                Funded by: The Finnish Nurses Association
                Funded by: The Rauno and Anne Puolimatka Foundation
                Categories
                Subject: Research Article
                Subject: Research Article
                Custom metadata
                source-schema-version-number 2.0
                cover-date May 2023
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:06.04.2023

                Keywords: action research,consumption,hand hygiene,hand rub,healthcare‐associated infection,intensive care
                Data availability:
                Keywords: action research, consumption, hand hygiene, hand rub, healthcare‐associated infection, intensive care

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