Compliance with Hand-hygiene Guidelines among Healthcare Workers, Kingdom of Saudi Arabia, 2017 Open Access

Alharbi, Naif (2017)

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Objectives: Evaluate the impact of previous and current Ministry of Health (MoH) hand-hygiene programs to improve healthcare workers (HCWs) compliance with WHO My Five Moments guidelines by measuring compliance rates in the Kingdom of Saudi Arabia (KSA) . These findings will inform the Infection Prevention and Control program (IPC) in the KSA MoH to improve adherence.

Methods : This is a secondary, observational study using MoH data for the first quarter of 2017 on observed, hand-hygiene practices among KSA MoH HCWs. Data were obtained from 173 MoH healthcare facilities across all 13 regions of KSA for the first quarter of 2017. Hand-hygiene compliance was assessed using the WHO Hand Hygiene Observation Form in three main units: Intensive Care Unit (ICU), Emergency Rooms (ERs) and Hemodialysis Unit (HU) as well as other healthcare facility unites.

Results : We included 84,083 opportunities (observations) collected from 173 KSA MoH healthcare facility. The overall hand-hygiene compliance rate among MoH HCWs was 77%. The highest compliance was observed among nurses (79%), in small (<100 beds) healthcare facilities (80%), and HU (81%). The poorest compliance was observed among physicians (75%), in large (>200 beds) healthcare facilities, and in ERs (73%).

Conclusion : Continuous hand-hygiene education, training, and monitoring plus an adequate infrastructure are key elements to improve hand hygiene practices. Our study estimated the overall compliance rate among KSA MoH HCWs to be 77%. Despite improvements we recommend both the creation of a digital data-entry and analyses system and special attention paid to educational campaigns for the identified predictors of poor hand-hygiene compliance.

Table of Contents

Table of Contents

Chapter 1 Introduction.. 8

Chapter 2 Literature Review... 10

Healthcare-acquired Infections (HAIs). 10

Global Burden of HAIs. 11

HAIs in WHO's Eastern Mediterranean Regional Office (EMRO). 12

Kingdom of Saudi Arabia (KSA). 12

Hand Hygiene. 13

Hand hygiene and the acquisition of HAIs. 16

Hand hygiene compliance rates in KSA.. 18

WHO's My Five Moments for Hand Hygiene. 18

Chapter 3 MANUSCRIPT.. 21

Method. 21

Study Design.. 21

Study Variables. 22

Ethics. 22

Results. 23

Discussion. 28

Conclusion. 30

References. 31

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