Hand hygiene in reducing transient flora on the hands of healthcare workers: An educational intervention.
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Date
2015-01
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Abstract
Aim: Hand hygiene has now been recognised as one of the most effective intervention to control the transmission of
infections in a hospital and education is an important tool to ensure its implementation. In order to convince the users
and as a part of education, it is important to generate evidence on the role of hand hygiene in reducing the bacterial fl ora
on their hands. The present study was undertaken in a tertiary care hospital to demonstrate the presence of bacterial fl ora
on the hands of healthcare workers (HCW) in different categories, to teach them proper hand hygiene technique using
alcohol-based hand rub and determine the outcome for reduction of bacteria. Materials and Methods: A total sample
size of 60 subjects including resident doctors, medical students, nurses and hospital attendants were included in the study
after obtaining informed consent. Each person was educated on the technique of hand hygiene with alcohol-based hand
rub and hand impressions were cultured before and after hand hygiene. All the subjects were also given a questionnaire
to assess their perception on hand hygiene. The WHO posters on proper hand hygiene were displayed in the appropriate
areas of the hospital in addition, as an educational tool. Results: Majority (42 out of 60) of the HCWs had bacterial
count up to 100 colonies or more on both hands before the application of hand rub while working in the hospital. After
use of alcohol hand rub with a proper hand hygiene technique, it was found that the percentage reduction was 95-99%
among doctors and nurses, 70% among hospital attendants and 50% among sanitary attendants. Staphylococcus aureus
was present on the hands of eight persons of which three were methicillin-resistant Staphylococcus aureus.
Conclusions: The study demonstrates that transient bacteria are present on the hands of HCWs but majority could be
removed by proper hand hygiene, which needs continuous education to be effective. It also shows that active education
by demonstrating the proper hand hygiene technique and direct observation of the practices, though demanding, are ideal
to understand the attitudes and practices of HCWs and helps in planning implementation strategies
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Keywords
Alcohol rub, education, hand hygiene
Citation
Kapil R, Bhavsar H K, Madan M. Hand hygiene in reducing transient flora on the hands of healthcare workers: An educational intervention. Indian Journal of Medical Microbiology. 2015 Jan-Mar ; 33 (1): 125-128.