An Investigation About Hand Hygiene Of "120"Health-care Workers

Objectives To investigate knowledge, perception and practice about hand hygiene of "120" ambulance services healthcare workers in a capital city, thus to understand pre-hospital healthcare workers’ hand hygiene situation, as well as to discuss measures to improve compliance of hand hygiene so that we can decrease HCAI, ensure patient safety and improve healthcare quality.Methods Purposive sampling was used.4emergency centers of one provincial capital city emergency system were selected. One of the emergency center belongs to university affiliated hospital, one belongs to a provincial hospital, one belongs to a municipal hospitals, the last one was directly subordinate to the emergency system. All the healthcare workers including learners of the centers were investigated. Field observation and questionnaire survey were carried out from August10,2013to November20th,2013. In the first stage, two observers using the standard Observation Form, publicized by the World Health Organization carried out field observation to record the practice of hand hygiene in workers during ambulance services provided by four service centers. In the second stage, a questionnaire survey was implemented. Subjects were investigated together and the questionnaires were returned after checking. The self-reported questionnaires included three parts:basic personal information sheet, Hand Hygiene Knowledge Questionnaire for Health-Care Workers and Perception Survey for Health-Care Workers. Descriptive analysis, parametric analyses (t-test, ANOVA analysis) and Pearson correlation analysis were performed to analyze the basic information, knowledge, perception and performance of subjects.Results A total of36questionnaires were distributed, of which36were returned and all of them (100%) were usable. Subjects were32.0(5=6.81) years old. Detailed information was as follows:1. The total score of Hand Hygiene Knowledge Questionnaire was26. The score was15.2(s=2.17) for "120" healthcare workers on average. Only19(52.8%) workers had received formal training in hand hygiene in the last three years. The awareness rates of the five moments(before touching patients, after body fluids exposure risk, before clean/aseptic procedures and after touching patients’ surroundings) was86.1%,83.3%,86.1%,83.3%and77.8%. There were significant differences in knowledge score by hospital and work years of healthcare workers.2. The attitude score of healthcare workers was8.97(s=1.859) on average, and they had a relative good attitude. As to hand hygiene improvement measures, workers thought "each health-care worker receives education on hand hygiene" was most effective, the average score of which was6.08(s=1.381). While "Patients are invited to remind health-care workers to perform hand hygiene" was thought to be the least effective, the average score of which was5.33(s=1.927). As to subjective norm, the head of department played a most important role, colleagues were second, while the patients were last. There was a positive correlation between self-report hand hygiene compliance and subjective norm, while a negative correlation with perceived behavioral control. There was no significant correlation between self-report hand hygiene compliance and attitude.3. A total of seven ambulances and80times of services were observed across a span of21days. The provision of hand hygiene facilities were found very limited in these ambulances. Of656times of presence of indictors for hand hygiene, overall the compliance rate was2.9%. The compliance rate was0(0/291),2%(1/51),12.5%(3/22),5.2%(16/307) and0(0/2) before touching patients, after body fluids exposure risk, before clean/aseptic procedures and after touching patients’ surroundings respectively.Conclusion Hand hygiene training rate of "120" healthcare workers was low. There is an urgent need to improve their knowledge level. The hand hygiene compliance rate was low, but the healthcare workers had a relatively good attitude to hand hygiene and they were glad to receive Multimodal Hand Hygiene Improvement Strategy.