article · Antimicrobial Resistance and Infection Control
Hand hygiene is recognised as the primary method to prevent healthcare-associated infections, yet data on adherence remains limited in developing regions. An observational study assessed hand hygiene compliance across five wards over a 24-hour period at Debre Berhan referral hospital in Ethiopia, monitoring 917 opportunities according to standard World Health Organization methods. The overall compliance rate was 22.0 percent, with consistent results across professional roles and working shifts. Notably, compliance dropped sharply during actions intended to protect patients, such as before patient contact at 2.4 percent and before aseptic procedures at 3.6 percent. Conversely, adherence was significantly higher during actions protecting the workers themselves, reaching 75.8 percent after body fluid exposure and 42.8 percent after patient contact. The findings highlight a critical need for targeted interventions to raise hygiene practices.
Healthcare-associated infections pose serious risks to patient recovery and hospital safety. Demonstrating that healthcare workers adhere to hygiene protocols primarily when protecting themselves rather than their patients pinpoints exact behavioral gaps. Understanding these specific failure points allows hospital administrators and health authorities to design precise training programmes and institutional policies that safeguard vulnerable patients from preventable clinical infections.
The abstract does not indicate an application pathway, as it focuses strictly on observational clinical compliance data rather than a commercial product or technology.
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BACKGROUND: Hand hygiene (HH) is recognized as the single most effective strategy for preventing health care-associated infections. In developing countries, data on hand hygiene compliance is available only for few health-care facilities. This study aimed to assess hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia. METHODS: This study employed the WHO hand hygiene observation method. Direct observation of the health care workers (HCWs) was conducted using an observation record form in five different wards. Trained and validated observers watched HCWs while they had direct contact with patients or their surroundings, and the observers then recorded all possible hand hygiene opportunities and hand hygiene actions. Observation was conducted over a 24 h period to minimize selection bias. More than 200 opportunities per ward were observed according to WHO recommendation, except in neonatal intensive care unit. HH compliance was calculated by dividing the number of times hand hygiene was performed by the total number of opportunities for hand hygiene. A 95% confidence interval (CI) was computed for compliance with the exact binomial method. RESULTS: A total of 917 hand hygiene opportunities were observed during the study. Overall HH compliance was 22.0% (95% CI: 19.4-24.9). HH compliance was similar across all professional categories and did not vary by shift. Levels of compliance were lower before patient contact (2.4%; 95% CI: 0.9-5.3), before an aseptic procedure (3.6%; 95% CI: 1.6-7.6) and after contact with patient surroundings (3.3%; 95% CI: 1.2-7.9), whereas better levels of compliance were found after body fluid exposure (75.8%; 95% CI: 68.0-82.3) and after patient contact (42.8%; 95% CI: 35.2-50.7). CONCLUSION: HH compliance of HCWs was found to be low in Debre Berhan referral hospital. Compliance with indications that protect patients from infection was lower than that protect the HCWs. The findings of this study indicate that HH compliance needs further improvement.
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DOI: 10.1186/s13756-017-0268-y
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