Abstract

Hand hygiene practices of 16 doctors and 22 nurses in the PICU, NICU and nursery were studied by direct observation. 18.7% doctors and 18.2% nurses correctly carried out hand-washing, the most common mistake being skipping of some steps in hand rubbing.

Hand hygiene is a modifiable risk factor for prevention of nosocomial infection. The importance of good hand hygiene practices cannot be overemphasized, yet many published studies conducted in intensive care units have reported that health care workers failed to wash their hands more than half of the recommended times, and in many case, the hand-washing procedure was inadequate(1).

Our hospital is a tertiary care center with annual delivery rate of 3600 to 4000. We have hand hygiene technique charts according to WHO recommen-dation(2) depicting six steps of hand rubbing, hanging near all wash basins in nursery, NICU and PICU. All the doctors (n=19) and nurses (n =24) working in the department were asked to clean their hands with soap solution before touching the babies. The charts showing the six steps were covered prior to the study. One person observed all the six steps of hand rubbing required for hand hygiene technique. Observations were recorded as correct/incorrect technique.

Three doctors and 2 nurses did not participate in the study. Of the rest, only 3/16 (18.7%) doctors and 4/22 (18.2%) nurses demonstrated the correct technique of hand washing. The most common fault observed was skipping one or more steps in hand rubbing.

Proper hand hygiene is the single most important means of preventing the transfer of potential pathogens from staff to patient and from patient to patient(3). There is a temporal relationship between hand hygiene practice and reduced infection rate. Studies have shown that compliance varied among hospitals from 16 to 81%(4). Barriers to compliance include under staffing and poor design of facilities, confusing and impractical guidelines and policies, failure to apply behavioral change theory fully, and insufficient commitment and enforcement by infection control personnel(4,5).

Nirmal Kumar,
Lokesh Kumar Tiwari,
Department of Pediatrics,
St. Stephens Hospital, Tis Hazari,
New Delhi-110054,
India.
E-mail: [email protected]