Journal of Anesthesia

, Volume 29, Issue 6, pp 899–903 | Cite as

Personal hand gel for improved hand hygiene compliance on the regional anesthesia team

  • Colby L. Parks
  • Kristopher M. Schroeder
  • Richard E. Galgon
Original Article

Abstract

Purpose

Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution’s policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team.

Methods

Healthcare providers assigned to the Acute Pain Service were observed for compliance with hand hygiene policy during a quality improvement initiative. Provider type and compliance were prospectively recorded in a database. Team members were then given a personal gel dispensing device and again observed for compliance. We have retrospectively reviewed this database to determine the effects of this intervention.

Results

Of the 307 encounters observed, 146 were prior to implementing personal gel dispensers. Compliance was 34 %. Pre- and post-patient contact compliances were 23 and 43 %, respectively. For 161 encounters after individual gel dispensers were provided, compliance was 63 %. Pre- and post-patient contact compliances were 53 and 72 %, respectively. Improvement in overall compliance from 34 to 63 % was significant.

Conclusion

On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.

Keywords

Hand hygiene Quality improvement Nerve block Anesthesia conduction Sanitation 

Notes

Compliance with ethical standards

Conflicts of interest

All funding was from institutional sources. There are no conflicts of interest to declare.

References

  1. 1.
    Magill SS, Edwars JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, Lynfield R, Maloney M, McAllister-Hollod L, Nadle J, Ray SM, Thompson DL, Wilson LE, Fridkin SK. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014;370:1198–208.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    American Society of Anesthesiologists. Recommendations for infection control for the practice of anesthesiology (third edition): Committee on Occupational Health. https://www.asahq.org/resources/resources-from-asa-committees. Accessed Jul 2015.
  3. 3.
    Centers for Disease Control and Prevention. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR. 2002;51:1–44.Google Scholar
  4. 4.
    World Health Organization. WHO guidelines on hand hygiene in health care. World Health Organization Health System Policies and Operations Evidence and Information for Policy 2009. http://www.who.int/gpsc/5may/tools/9789241597906/en/. Accessed Jul 2015.
  5. 5.
    Biddle C, Shah J. Quantification of anesthesia providers’ hand hygiene in a busy metropolitan operating room: what would Semmelweis think? Am J Infect Control. 2012;40:756–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Krediet AC, Kalkman CJ, Bonten MJ, Gigengack ACM, Barach P. Hand-hygiene practices in the operating theatre: an observational study. Br J Anaesth. 2011;107:553–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Andersson AE, Bergh I, Karlsson J, Eriksson BI, Nilsson K. The application of evidence-based measures to reduce surgical site infections during orthopedic surgery––report of a single-center experience in Sweden. Patient Saf Surg. 2012;6:11.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Loftus RW, Muffly MK, Brown JR, Beach ML, Koff MD, Corwin HL, Surgenor SD, Kirkland KB, Yeager MP. Hand contamination of anesthesia providers is an important risk factor for intraoperative bacterial transmission. Anesth Analg. 2011;112:98–105.CrossRefPubMedGoogle Scholar
  9. 9.
    Rowlands J, Yeager MP, Beach M, Patel HM, Huysman BC, Loftus RW. Video observation to map hand contact and bacterial transmission in operating rooms. Am J Infect Control. 2014;42:698–701.CrossRefPubMedGoogle Scholar
  10. 10.
    Koff MD, Loftus RW, Burchman CC, Schwartzman JD, Read ME, Henry ES, Beach ML. Reduction in intraoperative bacterial contamination of peripheral intravenous tubing through the use of a novel device. Anesthesiology. 2009;110:978–85.CrossRefPubMedGoogle Scholar
  11. 11.
    Loftus RW, Koff MD, Burchman CC, Schwartzman JD, Thorum V, Read ME, Wood TA, Beach ML. Transmission of pathogenic bacterial organisms in the anesthesia work area. Anesthesiology. 2008;109:399–407.CrossRefPubMedGoogle Scholar
  12. 12.
    Hebl JR. The importance and implications of aseptic techniques during regional anesthesia. Reg Anesth Pain Med. 2006;31:311–23.CrossRefPubMedGoogle Scholar
  13. 13.
    Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000;356:1307–12.CrossRefPubMedGoogle Scholar
  14. 14.
    Larson EL, Bryan JL, Adler LM, Blane CB. A multifaceted approach to changing handwashing behavior. Am J Infect Control. 1997;25:3–10.CrossRefPubMedGoogle Scholar
  15. 15.
    Kaplan LM, McGuckin M. Increasing handwashing compliance with more accessible sinks. Infect Control. 1986;7:408–10.PubMedGoogle Scholar
  16. 16.
    Giannitsioti E, Athanasia S, Antoniadou A, Fytrou H, Athanassiou K, Bourvani P, Kanellakopoulou K, Kouvelas K, Papadopoulos A, Plachouras D, Giamarellou H. Does a bed rail system of alcohol-based handrub antiseptic improve compliance of health care workers with hand hygiene? Results from a pilot study. Am J Infect Control. 2009;37:160–3.CrossRefPubMedGoogle Scholar
  17. 17.
    Hussein R, Khakoo R, Hobbs G. Hand hygiene practices in adult versus pediatric intensive care units at a university hospital before and after intervention. Scand J Infect Dis. 2007;39:566–70.CrossRefPubMedGoogle Scholar
  18. 18.
    Traore O, Hugonnet S, Lubbe J, Griffiths W, Pittet D. Liquid versus gel handrub formulation: a prospective intervention study. Crit Care. 2007;11:R52.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Erasmus V, Brouwer W, van Beeck EF, Oenema A, Daha TJ, Richardus H, Vos MC, Brug J. A qualitative exploration of reasons for poor hand hygiene among hospital workers: lack of positive role models and of convincing evidence that hand hygiene prevents cross-infection. Infect Control Hosp Epidemiol. 2009;30:415–9.CrossRefPubMedGoogle Scholar
  20. 20.
    McInnes E, Phillips R, Middleton S, Gould D. A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene. BMC Infect Dis. 2014;14:611.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Pittet D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiiol. 2000;21:381–6.CrossRefGoogle Scholar
  22. 22.
    Fuller C, Besser S, Savage J, McAteer J, Stone S, Michie S. Application of a theoretical framework for behavior change to hospital workers’ real-time explanations for noncompliance with hand hygiene guidelines. Am J Infect Control. 2014;42:106–10.CrossRefPubMedGoogle Scholar
  23. 23.
    Pittet D, Mourouga P, Perneger TV. Compliance with handwashing in a teaching hospital. Ann Intern Med. 1999;130:126–30.CrossRefPubMedGoogle Scholar
  24. 24.
    Megeus V, Nilsson K, Karlsson J, Eriksson B, Andersson AE. Hand hygiene and aseptic techniques during routine anesthetic care––observations in the operating room. Antimicrob Resist Infect Control. 2015;4:5.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 2010;31:283–94.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2015

Authors and Affiliations

  • Colby L. Parks
    • 1
  • Kristopher M. Schroeder
    • 1
  • Richard E. Galgon
    • 1
  1. 1.Department of AnesthesiologyUniversity of Wisconsin-MadisonMadisonUSA

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