HSR&D Citation Abstract
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Chang NN, Reisinger HS, Schweizer ML, Jones M, Chrischilles E, Chorazy M, Huskins C, Herwaldt L. Hand Hygiene Compliance at Critical Points of Care. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2020 Feb 8.
Most papers on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers are non-compliant. We assessed how task type affected healthcare workers' hand hygiene compliance.
We linked consecutive tasks individual healthcare workers performed during the STAR*ICU study into care sequences and identified task pairs--two consecutive tasks and the intervening HH opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, healthcare worker type, and compliance at prior opportunities.
Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR] 0.97; 95% confidence interval [CI] 0.95-0.98) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR 1.12; 95% CI 1.10-1.13). Nurses were more likely to perform both critical and contaminating tasks but nurses' hand hygiene compliance was better than physicians' (aOR 0.94; 95% CI 0.91-0.97) and other healthcare workers' compliance (aOR 0.87; 95% CI 0.87-0.94).
Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.