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      Patient participation in hand hygiene among health professionals Translated title: Participação do paciente na higienização das mãos entre profissionais de saúde Translated title: Participación del paciente en la higienización de las manos entre profesionales de salud

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          Abstract

          ABSTRACT Objective: To investigate the perception and attitude of health professionals (HPs) about the patient participation in hand hygiene (HH). Method: A cross-sectional study with 150 HPs from a university hospital in Brazil. A descriptive analysis was conducted. Results: Simple hand hygiene was the preferred method of HPs, rather than hand rubbing with alcohol-based solutions. A total of 83.3% of the HPs supported the patient participation in reminding them about HH, but 48% reported that they would feel uncomfortable; 45.3%, comfortable; and 20.7% were familiar with the "Patients for Patient Safety" program. Conclusion: HPs showed limited knowledge about HH, opposing recommendations on the topic. The contradiction between the HPs acceptance and attitude when questioned by the patient regarding HH was revealed, reflecting a lack of knowledge about the WHO program and the need to implement educational practices in health.

          Translated abstract

          RESUMO Objetivo: Investigar a percepção e atitude dos profissionais de saúde (PS) sobre a participação do paciente na higienização das mãos (HM). Método: Estudo transversal, realizado com 150 PS de um hospital universitário do Brasil. Realizou-se uma análise descritiva. Resultados: A higiene simples das mãos foi o método preferido dos PS, em detrimento da fricção com preparação alcoólica. Dos PS, 83,3% apoiavam à participação do paciente em lembrá-los sobre a HM, mas 48% relataram que se sentiriam desconfortáveis; 45,3%, confortáveis; e 20,7% conheciam o programa "Paciente Pela Segurança do Paciente". Conclusão: PS mostraram conhecimento limitado sobre a HM, contrapondo as recomendações sobre o tema. Revelou-se a contradição entre a aceitação e atitude dos PS em serem questionados pelo paciente a respeito da HM, refletindo desconhecimento do programa da OMS e a necessidade de implementação de práticas educativas em saúde.

          Translated abstract

          RESUMEN Objetivo: Investigar la percepción y actitud de profesionales de salud (PS) sobre la participación del paciente en la higienización de manos (HM). Método: Estudio transversal, realizado con 150 PS de un hospital universitario de Brasil. Se realizó un análisis descriptivo. Resultados: La higiene simple de manos fue el método preferido de los PS, en detrimento de la fricción con preparación alcohólica. De los PS, 83,3% apoyaban a la participación del paciente en recordarlos sobre la HM, pero 48% relataron que se sentirían incómodos; 45,3%, confortables; y 20,7% conocían el programa "Pacientes en Defensa de su Seguridad". Conclusión: Los PS mostraron conocimiento limitado sobre HM, contraponiendo las recomendaciones sobre el tema. Además, revelaron contradicción entre su aceptación y actitud a respecto de que sean cuestionados por el paciente sobre la HM, refletando desconocimiento del programa de la OMS y la necesidad de implementación de prácticas educativas en salud.

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          Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study.

          Health-care-associated infections are a major threat to patient safety worldwide. Transmission is mainly via the hands of health-care workers, but compliance with recommendations is usually low and effective improvement strategies are needed. We assessed the effect of WHO's strategy for improvement of hand hygiene in five countries. We did a quasi-experimental study between December, 2006, and December, 2008, at six pilot sites (55 departments in 43 hospitals) in Costa Rica, Italy, Mali, Pakistan, and Saudi Arabia. A step-wise approach in four 3-6 month phases was used to implement WHO's strategy and we assessed the hand-hygiene compliance of health-care workers and their knowledge, by questionnaire, of microbial transmission and hand-hygiene principles. We expressed compliance as the proportion of predefined opportunities met by hand-hygiene actions (ie, handwashing or hand rubbing). We assessed long-term sustainability of core strategy activities in April, 2010. We noted 21,884 hand-hygiene opportunities during 1423 sessions before the intervention and 23,746 opportunities during 1784 sessions after. Overall compliance increased from 51.0% before the intervention (95% CI 45.1-56.9) to 67.2% after (61.8-72.2). Compliance was independently associated with gross national income per head, with a greater effect of the intervention in low-income and middle-income countries (odds ratio [OR] 4.67, 95% CI 3.16-6.89; p<0.0001) than in high-income countries (2.19, 2.03-2.37; p<0.0001). Implementation had a major effect on compliance of health-care workers across all sites after adjustment for main confounders (OR 2.15, 1.99-2.32). Health-care-workers' knowledge improved at all sites with an increase in the average score from 18.7 (95% CI 17.8-19.7) to 24.7 (23.7-25.6) after educational sessions. 2 years after the intervention, all sites reported ongoing hand-hygiene activities with sustained or further improvement, including national scale-up. Implementation of WHO's hand-hygiene strategy is feasible and sustainable across a range of settings in different countries and leads to significant compliance and knowledge improvement in health-care workers, supporting recommendation for use worldwide. WHO, University of Geneva Hospitals, the Swiss National Science Foundation, Swiss Society of Public Health Administration and Hospital Pharmacists. Copyright © 2013 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.
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            WHO guidelines on hand hygiene in health care: first global patient safety challenge - clean care is safer care

            (2009)
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              Involving the patient to ask about hospital hand hygiene: a National Patient Safety Agency feasibility study.

              Healthcare-associated infections (HAIs) affect at least 300,000 patients annually in the UK and represent a significant, yet largely preventable, burden to healthcare systems. Hand hygiene by healthcare workers (HCWs) is the leading prevention measure, but compliance with good practice is generally low. The UK National Patient Safety Agency surveyed the public, inpatients, and HCWs, particularly frontline clinical staff and infection control nurses, in five acute care hospitals to determine whether they agreed that a greater level of involvement and engagement with patients would contribute to increased compliance with hand hygiene and reduce HAIs. Fifty-seven percent (302/530) of the public were unlikely to question doctors on the cleanliness of their hands as they assumed that they had already cleaned them. Forty-three percent (90/210) of inpatients considered that HCWs should know to clean their hands and trusted them to do so, and 20% (42/210) would not want HCWs to think that they were questioning their professional ability to do their job correctly. Most HCWs surveyed (178/254, 71%) said that HAI could be reduced to a greater or lesser degree if patients asked HCWs if they had cleaned their hands before touching them. Inviting patients to remind HCWs about hand hygiene through the provision of individual alcohol-based hand-rub containers and actively supporting an 'It's OK to ask' attitude were perceived as the most useful interventions by both patients and HCWs. However, further work is required to refute the myth among HCWs that patient involvement undermines the doctor- or HCW-patient relationship. Copyright © 2010 World Health Organization. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                reben
                Revista Brasileira de Enfermagem
                Rev. Bras. Enferm.
                Associação Brasileira de Enfermagem (Brasília, DF, Brazil )
                0034-7167
                1984-0446
                April 2018
                : 71
                : 2
                : 259-264
                Affiliations
                [1] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1Postgraduate Program in Nursing Brazil
                Article
                S0034-71672018000200259
                10.1590/0034-7167-2016-0124
                29412281
                a122c690-3313-443c-8c4c-89545d5bb5b3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 March 2017
                : 07 April 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 6
                Product

                SciELO Brazil


                Infección Hospitalera,Health Professionals,Hand Hygiene,Patient Participation,Patient Safety,Hospital Infection,Personal de la Salud,Higiene de las Manos,Participación del Paciente,Seguridad del Paciente,Pessoal da Saúde,Higiene das Mãos,Participação do Paciente,Segurança do Paciente,Infecção Hospitalar

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