Raji Baidya, Sumitra Gurung, Mahesh Raj Joshi, Rashmi Maharjan, Archana Shrestha, Sachin Shakya, Kapendra Shekhar Amatya, Bijesh Raj Ghimire, Sudip Shrestha, Hospital Infection Control Unit, Nepal Cancer Hospital and Research Center Pvt. Ltd., Harisiddhi, Lalitpur, Nepal, 2016.
Soiled or contaminated hands are closely related with spread of Healthcare Associated Infections (HAIs). Proper hand hygiene, either by hand washing or hand disinfection plays an essential role in preventing the transmission of HAIs and an effective hand hygiene program should be the backbone of a hospital’s Infection Control Program. Nepal Cancer Hospital and Research Center Pvt. Ltd. (NCHRC) has actively participated in implementation of comprehensive infection control policies and along with an active surveillance and prevention activities, as well as effective staff training. In this study, we monitored the overall compliance of hand hygiene during routine patient care in NCHRC both before and during implementation of hand-hygiene campaign. The importance of hand hygiene was not adequately recognized and promotional activities were being ignored by health-care workers and poor compliance had been registered repeatedly as hand hygiene compliance plateau at just 64% (July 2015, before hand hygiene campaign). Along with the strong hospital infection control policies, we designed a campaign to promote hand hygiene practices by implementing the program that includes,
- Conduction of hand hygiene educational training sessions: To routinely provide hand hygiene training class to all newly hired staff.
- Conduction of hand hygiene quizzes: To build enthusiasm.
- Monthly hand hygiene excellence award based on monthly hand hygiene audit using WHO hand hygiene observation toolkit: To motivate and appreciate good hand hygiene practices.
- Enforcing online Hand hygiene training course offered by Hand Hygiene Australia.
After implementation of these programs, we observed compliance persist at 72.57% during the initial months of campaign (September- December 2015). Later the compliance progressively increased to 84.42% (April 2016- July 2016).The statistical analysis showed significant improvement in hand hygiene compliance as we compared the data between September 2015- December 2015 to April 2016- July 2016. The hand hygiene practice was found improved in nurses and attendants than compared to doctors. During the same period, alcohol hand rub consumption showed similar trend increasing from 26.11 Litre per 1000 patient-day (September 2015- December 2015) to 32.86 Litre per 1000 patient-day (April 2016- July 2016).
The results showed an improved compliance in hand hygiene.It is essential to adopt innovative programs to promote and improve hand hygiene compliance.