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Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study
BACKGROUND: Health-care-associated infection (HCAI) is a big challenge in both low- and high-income countries. Around childbirth, infection is among the main causes of maternal and perinatal morbidity and mortality. Appropriate hand hygiene practice is a simple and cost-effective way of reducing HCA...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The East African Health Research Commission
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279249/ https://www.ncbi.nlm.nih.gov/pubmed/34308206 http://dx.doi.org/10.24248/EAHRJ-D-19-00014 |
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author | Sengoka, Enna Rasmussen, Lærke Msuya, Marycelina Kisigo, Godfrey Sørensen, Bjarke Lund Chilongola, Jaffu Maro, Eusebious |
author_facet | Sengoka, Enna Rasmussen, Lærke Msuya, Marycelina Kisigo, Godfrey Sørensen, Bjarke Lund Chilongola, Jaffu Maro, Eusebious |
author_sort | Sengoka, Enna |
collection | PubMed |
description | BACKGROUND: Health-care-associated infection (HCAI) is a big challenge in both low- and high-income countries. Around childbirth, infection is among the main causes of maternal and perinatal morbidity and mortality. Appropriate hand hygiene practice is a simple and cost-effective way of reducing HCAIs. This study aimed to assess the baseline performance and knowledge of proper hand hygiene during caesarean sections and the impact of interventions guided by a criterion-based audit at a tertiary health facility in Tanzania. METHODS: A noncontrolled, before-and-after intervention study, guided by a criterion-based audit, was carried out. A criterion based checklist was used for direct observations of hand hygiene performance during cesarean section. A self-administered questionnaire was used to assess knowledge on infection prevention. Performance was compared before and after a half-way intervention. RESULTS: At baseline, low-quality hand hygiene performance was observed. Significant improvements of hand hygiene performance were observed for a number of criteria. Long nails: performance reduction from 15 (25%) to 3 (5%) (P=.04), polished nails: from 11 (18%) to 1 (2%) (P=.04), a score increase in hand wash with water from 43.8 (73%) to 60 (100%) (P=.001). Postoperatively, correct glove removal increased from 20 (33%) to 37.8 (66%) (P=.01). Alcohol-based hand rub use increased from 2 (3%) to 21 (35%) (P=.001). The number of health-care workers who did not wash hands after procedure with either water or alcohol-based hand rub reduced from 35 (58%) to 10 (17%) (P=.001). After the intervention, poor knowledge among health-care workers reduced from 7 (39%) to 3 (17%), while moderate knowledge increased from 8 (44%) to 12 (67%). CONCLUSION: Feedback, discussion of findings, training, visual reminders, and distribution of alcohol-based hand rub, as part of a criterion-based audit is a powerful way of improving hand hygiene performance and knowledge in surgical wards. |
format | Online Article Text |
id | pubmed-8279249 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The East African Health Research Commission |
record_format | MEDLINE/PubMed |
spelling | pubmed-82792492021-07-22 Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study Sengoka, Enna Rasmussen, Lærke Msuya, Marycelina Kisigo, Godfrey Sørensen, Bjarke Lund Chilongola, Jaffu Maro, Eusebious East Afr Health Res J Original Articles BACKGROUND: Health-care-associated infection (HCAI) is a big challenge in both low- and high-income countries. Around childbirth, infection is among the main causes of maternal and perinatal morbidity and mortality. Appropriate hand hygiene practice is a simple and cost-effective way of reducing HCAIs. This study aimed to assess the baseline performance and knowledge of proper hand hygiene during caesarean sections and the impact of interventions guided by a criterion-based audit at a tertiary health facility in Tanzania. METHODS: A noncontrolled, before-and-after intervention study, guided by a criterion-based audit, was carried out. A criterion based checklist was used for direct observations of hand hygiene performance during cesarean section. A self-administered questionnaire was used to assess knowledge on infection prevention. Performance was compared before and after a half-way intervention. RESULTS: At baseline, low-quality hand hygiene performance was observed. Significant improvements of hand hygiene performance were observed for a number of criteria. Long nails: performance reduction from 15 (25%) to 3 (5%) (P=.04), polished nails: from 11 (18%) to 1 (2%) (P=.04), a score increase in hand wash with water from 43.8 (73%) to 60 (100%) (P=.001). Postoperatively, correct glove removal increased from 20 (33%) to 37.8 (66%) (P=.01). Alcohol-based hand rub use increased from 2 (3%) to 21 (35%) (P=.001). The number of health-care workers who did not wash hands after procedure with either water or alcohol-based hand rub reduced from 35 (58%) to 10 (17%) (P=.001). After the intervention, poor knowledge among health-care workers reduced from 7 (39%) to 3 (17%), while moderate knowledge increased from 8 (44%) to 12 (67%). CONCLUSION: Feedback, discussion of findings, training, visual reminders, and distribution of alcohol-based hand rub, as part of a criterion-based audit is a powerful way of improving hand hygiene performance and knowledge in surgical wards. The East African Health Research Commission 2019 2019-11-29 /pmc/articles/PMC8279249/ /pubmed/34308206 http://dx.doi.org/10.24248/EAHRJ-D-19-00014 Text en © The East African Health Research Commission 2019 https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Articles Sengoka, Enna Rasmussen, Lærke Msuya, Marycelina Kisigo, Godfrey Sørensen, Bjarke Lund Chilongola, Jaffu Maro, Eusebious Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title | Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title_full | Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title_fullStr | Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title_full_unstemmed | Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title_short | Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study |
title_sort | criterion-based audit of hand hygiene performance during caesarean section at a referral hospital in northern tanzania: an uncontrolled interventional study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279249/ https://www.ncbi.nlm.nih.gov/pubmed/34308206 http://dx.doi.org/10.24248/EAHRJ-D-19-00014 |
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