An Interventional Hand Hygiene Study at an Oncology Center

Tuesday, 14 July 2009: 10:50 AM

Jeanne Siegel, PhD, ARNP, BC
Nursing, University of Miami School of Nursing and Health Studies, Coral Gables, FL

Learning Objective 1: discuss the Center for Disease Control guidelines for hand hygiene and their role in preventing infection.

Learning Objective 2: examine the lack of compliance to hand hygiene in this health care settings.

Purpose: The purpose of this study was to measure the effect of introducing a new hand hygiene product on compliance to hand hygiene among healthcare workers (HCWs). In an effort to reduce HAI’s and increase awareness, an interventional study was conducted at an oncology center to investigate hand hygiene compliance of HCWs before and after patient contact.

Background/Significance: Healthcare Associated Infections (HAI’s) continue to affect patient morbidity and mortality, and contribute to the rising cost of healthcare.  A number of factors have been identified that contribute HAI’s in patients with cancer including increased antimicrobial resistance, chemotherapeutic and radiation therapies.  In addition, catheters and surgeries place cancer patients at greater risk.

Methods: The study was conducted at a university affiliated oncology acute care hospital and its associated outpatient treatment clinics.  This quasi-experimental study assessed hand hygiene compliance among 47 healthcare workers (HCWs) before and after routine clinical procedures.  Observation data was collected for 2 weeks before introduction of a hand hygiene sanitizer spray and for 14 weeks following the spray’s introduction.  After the spray was discontinued for 2-3 weeks an additional observation period of 2 weeks was performed. Data collection also included a feasibility study of the hand sanitizer spray.

Results: Nearly equal numbers licensed and non-licensed HCWs participated in the study. Self reported ethnicity of the sample was African American (40.4%), Asian (27.7%), Hispanic (17%), Caucasian (6.4%), and other (6.4%); 2.1% provided no response.  Feasibility studies demonstrated high level of satisfaction with the product.  Despite the introduction of a hand sanitizer product compliance levels remained pre procedure (52 -57%) and post (80-81%).

Conclusion: Although HCWs express concern about infection control and antimicrobial resistance they remain noncompliant approximately 20-45% of the time to basic hand hygiene guidelines set forth by the CDC.