Practice and compliance of essential handwashing among healthcare workers at a regional referral hospital in Uganda: A quality improvement and evidence-based practice

Abstract

Introduction: Hospital acquired infections (HAI) are a global public health problem. Improper hand hygiene (HH) practices serve as means of infection transmission in hospital wards and proper HH is the single most important means of reducing HAI. The WHO recommends five moments of HH, creating the pillars for effective HH. Objectives: To assess the availability and suitability of essential hand washing facilities, assess essential hand washing practice and compliance among healthcare workers (HCWs) on surgical and medical ED, ICU, medical and surgical general wards. Methods: A descriptive cross-sectional design was employed. HCWs providing care to patients admitted on the selected wards were recruited. Data were collected by trained research assistants (RAs) from participants who fulfilled the eligibility criteria using a checklist for HH facilities and HH observation checklist. Data were analysed using SPSS. Results: Most of the wards had inadequate HH resources. The sink to bed ratio ranged from 1:1 to 1:33. HH resources were not always available. A total of 287 HH opportunities were observed from the five wards. The overall HH compliance before and after patient contact were 25.4% and 33.8% respectively. ANOVA showed ICU had significantly higher rates of HH than surgical ward before and after patient contact. HCWs in ICU and surgical emergency were 4.86 and 3.12 times respectively more likely to perform HH as compared to medical ward. No significant difference in HH compliance among professional categories before or after patient contact was detected. Recommendations: The low rates of HH compliance reflect the need to put more emphasis on HH for improvement in the healthcare setting