BMC Veterinary Research | |
Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance | |
J Scott Weese1  Jan M Sargeant2  Maureen EC Anderson1  | |
[1] Department of Pathobiology, University of Guelph, Guelph, ON, Canada;Department of Population Medicine, University of Guelph, Guelph, ON, Canada | |
关键词: Intervention; Video observation; Infection control; Hand hygiene; Companion animal; Veterinary; | |
Others : 1119195 DOI : 10.1186/1746-6148-10-106 |
|
received in 2013-06-06, accepted in 2014-05-01, 发布年份 2014 | |
【 摘 要 】
Background
Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance.
Results
Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times.
Conclusions
Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a component of a multimodal hand hygiene campaign. Improving the infection control culture in veterinary medicine would facilitate future campaigns and studies in this area, as well as overall patient and staff safety.
【 授权许可】
2014 Anderson et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150208050620427.pdf | 999KB | download | |
Figure 4. | 28KB | Image | download |
Figure 3. | 86KB | Image | download |
Figure 2. | 64KB | Image | download |
Figure 1. | 58KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
【 参考文献 】
- [1]Allegranzi B, Pittet D: Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect 2009, 73:305-315.
- [2]Pittet D, Allegranzi B, Boyce J: The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations. Infect Control Hosp Epidemiol 2009, 30:611-622.
- [3]Fung CH, Lim Y-W, Mattke S, Damberg C, Shekelle PG: Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med 2008, 148:111-123.
- [4]Muller MP, Detsky AS: Public reporting of hospital hand hygiene compliance–helpful or harmful? J Am Med Assoc 2010, 304:1116-1117.
- [5]DiDiodato G: An alternative methodology for interpretation and reporting of hand hygiene compliance data. Am J Infect Control 2012, 40:332-335.
- [6]Scheftel JM, Elchos BL, Cherry B, DeBess EE, Hopkins SG, Levine JF, Williams CJ, Bell MR, Dvorak GD, Funk RH, Just SD, Samples OM, Schaefer EC, Silvia CA: Compendium of veterinary standard precautions for zoonotic disease prevention in veterinary personnel: National Association of State Public Health Veterinarians Veterinary Infection Control Committee 2010. J Am Vet Med Assoc 2010, 237:1403-1422.
- [7]Australian Veterinary Association: Guidelines for Veterinary Personal Biosecurity. 1st edition. St. Leonards, NSW: Australian Veterinary Association; 2011:1-59.
- [8]Canadian Committee on Antibiotic Resistance: Infection Prevention and Control Best Practices for Small Animal Veterinary Clinics. 1st edition. Guelph, Ontario: Canadian Commitee on Antibiotic Resistance; 2008.
- [9]Shea A, Shaw S: Evaluation of an educational campaign to increase hand hygiene at a small animal veterinary teaching hospital. J Am Vet Med Assoc 2012, 240:61-64.
- [10]Wright JG, Jung S, Holman RC, Marano NN, McQuiston JH: Infection control practices and zoonotic disease risks among veterinarians in the United States. J Am Vet Med Assoc 2008, 232:1863-1872.
- [11]Nakamura RK, Tompkins E, Braasch EL, Martinez JG, Bianco D: Hand hygiene practices of veterinary support staff in small animal private practice. J Small Anim Pract 2012, 53:155-160.
- [12]Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee, HICPAC SHEA APIC IDSA Hand Hygiene Task Force: Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control 2002, 30:S1-S46.
- [13]Sax H, Allegranzi B, Chraïti M-N, Boyce J, Larson EL, Pittet D: The World Health Organization hand hygiene observation method. Am J Infect Control 2009, 37:827-834.
- [14]Boyce JM: Hand hygiene compliance monitoring: current perspectives from the USA. J Hosp Infect 2008, 70(Suppl 1):2-7.
- [15]Eckmanns T, Bessert J, Behnke M, Gastmeier P, Ruden H: Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infect Control Hosp Epidemiol 2006, 27:931-934.
- [16]Haidet KK, Tate J, Divirgilio-Thomas D, Kolanowski A, Happ MB: Methods to improve reliability of video-recorded behavioral data. Res Nurs Health 2009, 32:465-474.
- [17]Chapman B, Eversley T, Fillion K, Maclaurin T, Powell D: Assessment of food safety practices of food service food handlers (risk assessment data): testing a communication intervention (evaluation of tools). J Food Prot 2010, 73:1101-1107.
- [18]Redmond EC, Griffith CJ: A comparison and evaluation of research methods used in consumer food safety studies. Int J Cons Stud 2003, 27:17-33.
- [19]Forrester LA, Bryce EA, Mediaa AK: Clean Hands for Life: results of a large, multicentre, multifaceted, social marketing hand-hygiene campaign. J Hosp Infect 2010, 74:225-231.
- [20]Randle J, Clarke M, Storr J: Hand hygiene compliance in healthcare workers. J Hosp Infect 2006, 64:205-209.
- [21]Public Health Ontario: Just Clean Your Hands. 2008. http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/ webcite
- [22]Jenner E, Jones F, Fletcher B, Miller L, Scott G: Hand hygiene posters: selling the message. J Hosp Infect 2005, 59:77-82.
- [23]Naikoba S, Hayward A: The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review. J Hosp Infect 2001, 47:173-180.
- [24]Anderson MEC: Video Observation of Infection Control Practices in Veterinary Clinics and a Petting Zoo, with Emphasis on Hand Hygiene and Interventions to Improve Hand Hygiene Compliance. PhD thesis. University of Guelph, Department of Pathobiology 2013.
- [25]Sax H, Allegranzi B, Uçkay I, Larson E, Boyce J, Pittet D: “My five moments for hand hygiene”: a user-centred design approach to understand, train, monitor and report hand hygiene. J Hosp Infect 2007, 67:9-21.
- [26]Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP: Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000, 160:1017-1021.
- [27]Novoa AM, Pi-Sunyer T, Sala M, Molins E, Castells X: Evaluation of hand hygiene adherence in a tertiary hospital. Am J Infect Control 2007, 35:676-683.
- [28]Bahal A, Karamchandani D, Fraise AP, McLaws M-L: Hand hygiene compliance: universally better post-contact than pre-contact in healthcare workers in the UK and Australia. Br J Infect Contr 2007, 8:24-28.
- [29]Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF: Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010, 31:283-294.
- [30]Creedon SA: Healthcare workers’ hand decontamination practices: compliance with recommended guidelines. J Adv Nurs 2005, 51:208-216.
- [31]Pittet D: Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000, 21:381-386.
- [32]Pratt RJ, Pellowe CM, Wilson JA, Loveday HP, Harper PJ, Jones SRLJ, McDougall C, Wilcox MH: epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2007, 65S:S1-S64.
- [33]Siegel JD, Rhinehart E, Jackson M, Chiarello L, Committee HCICPA: Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007, 2007(35):S65-S164.
- [34]Kampf G, Kramer A: Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004, 17:863-893.
- [35]Patrick DR, Findon G, Miller TE: Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect 1997, 119:319-325.
- [36]Redway K, Fawdar S: A comparative study of three different hand drying methods: paper towel, warm air dryer, jet air dryer. Brussels: European Tissue Symposium; 2008. http://www.europeantissue.com/pdfs/090402-2008%20WUS%20Westminster%20University%20hygiene%20study,%20nov2008.pdf webcite
- [37]Larson EL: APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995, 23:251-269.
- [38]Greene CE (Ed): Infectious Diseases of the Dog and Cat. 4th edition. St. Louis: Elsevier Saunders; 2012.
- [39]Ontario Ministry of Health Long-Term Care: How to handwash / handrub mini poster. 2009. http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-Hospitals-Education-and-training.aspx webcite
- [40]Rocha LA, Ferreira de Almeida E, Borges L, Gontijo Filho PP: Changes in hands microbiota associated with skin damage because of hand hygiene procedures on the health care workers. Am J Infect Control 2009, 37:155-159.
- [41]Taylor LJ: An evaluation of handwashing techniques-1. Nurs Times 1978, 74:54-55.
- [42]Burger A, Wijewardena C, Clayson S, Greatorex RA: Bare below elbows: does this policy affect handwashing efficacy and reduce bacterial colonisation? Ann R Coll Surg Engl 2011, 93:13-16.
- [43]Fagernes M, Lingaas E: Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers. J Adv Nurs 2011, 67:297-307.
- [44]Trick WE, Vernon MO, Hayes RA, Nathan C, Rice TW, Peterson BJ, Segreti J, Welbel SF, Solomon SL, Weinstein RA: Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital. Clin Infect Dis 2003, 36:1383-1390.
- [45]Montville R, Chen Y, Schaffner DW: Risk assessment of hand washing efficacy using literature and experimental data. Int J Food Microbiol 2002, 73:305-313.
- [46]Salisbury DM, Hutfilz P, Treen LM, Bollin GE, Gautam S: The effect of rings on microbial load of health care workers’ hands. Am J Infect Control 1997, 25:24-27.
- [47]Hautemaniere A, Cunat L, Diguio N, Vernier N, Schall C, Daval M-C, Ambrogi V, Tousseul S, Hunter PR, Hartemann P: Factors determining poor practice in alcoholic gel hand rub technique in hospital workers. J Infect Publ Health 2010, 3:25-34.
- [48]Ashraf MS, Hussain SW, Agarwal N, Ashraf S, El-Kass G, Hussain R, Nemat H, Haller N, Pekmezaris R, Sison C, Walia R, Eichorn A, Cal C, Dlugacz Y, Edwards BT, Louis B, Alano G, Wolf-Klein G: Hand hygiene in long-term care facilities: a multicenter study of knowledge, attitudes, practices, and barriers. Infect Control Hosp Epidemiol 2010, 31:758-762.
- [49]Pittet D: Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 2001, 7:234-240.
- [50]Olsen RJ, Lynch P, Coyle MB, Cummings J, Bokete T, Stamm WE: Examination gloves as barriers to hand contamination in clinical practice. J Am Med Assoc 1993, 270:350-353.
- [51]Gould DJ, Moralejo D, Drey N, Chudleigh JH: Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev 2010, 9:CD005186. doi:10.1002/14651858.CD005186.pub3
- [52]Larson EL, Early E, Cloonan P, Sugrue S, Parides M: An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000, 26:14-22.
- [53]Haas JP, Larson EL: Measurement of compliance with hand hygiene. J Hosp Infect 2007, 66:6-14.
- [54]Anderson MEC, Foster BA, Weese JS: Observational study of patient and surgeon preoperative preparation in ten companion animal clinics in Ontario. Canada BMC Vet Res 2013, 9:194. BioMed Central Full Text