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Nurses' views on individual and organizational barriers to hand hygiene in Tabriz neonatal wards, 2013

Number of pages: 108 File Format: word File Code: 31987
Year: Not Specified University Degree: Master's degree Category: Medical Sciences
Tags/Keywords: hand hygiene - Hospital infections - hygiene - Individual barriers - Neonatal wards - Nurses' point of view
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  • Summary of Nurses' views on individual and organizational barriers to hand hygiene in Tabriz neonatal wards, 2013

    Research title:
    Nurses' point of view regarding individual and organizational barriers to hand hygiene compliance in the neonatal wards of Tabriz, 2013
    Field of research:
    Infections caused by the provision of healthcare and treatment are one of the most common causes of death and increase in disability in Patients admitted to hospitals in developing and advanced countries are considered. The survey conducted by the World Health Organization in 55 hospitals located in 14 countries of the world, including the countries of the Eastern Mediterranean region, confirmed the prevalence of infections caused by the provision of health care in the inpatient departments of the hospital with an average of 8.7%(1). These infections are a threat to the patient's health and by prolonging the stay in the hospital, they bring many complications (2). On average, 7% of hospitalized patients in high-income countries and about 15% of patients in low- and middle-income countries suffer from hospital infections (3, 4).
    According to the estimates of the disease control management of the Ministry of Health of Iran, the incidence of hospital infections in patients hospitalized in hospitals is about 10-15%, and if only 10% of infections lead to death, the annual witness is about 60 Thousands of patients will die as a result of this problem, which confirms the need to pay attention to the control of hospital infections in the country's health system (5). In another report, the rate of hospital infections in developed countries is 5-10% and in developing countries it is 25% and above (6). According to available statistics, more than one and a half million people suffer from hospital infections at any time around the world. Hospital infections are more common in developing countries due to lack of personnel, lack of hygiene, lack of equipment and overcrowding of patients. In Iran, patients admitted to hospitals suffer from hospital infections depending on the underlying disease and the type of treatment that is performed for them, and the statistics are different according to the department and type of specialty of the hospital(7).
    Of course, the statistics of hospital infections in our country are not known due to the lack of a precise system for recording statistics, as a result, when the cause of the infection is not known, the control system will also be defective. Today, these infections impose a huge burden on the health system, which constitutes a significant part of the complications of hospitalized patients. Despite the efforts to make disinfectant solutions and antibiotics, hospital infections are still one of the problems of hospital administration in the world health system. Global statistics show that 1% of patients in the neurology department and 60% in the burn department suffer from hospital infections (5). On the other hand, hospital infections are one of the most important problems in special departments, affecting 20% ??of patients admitted to these departments and increasing the mortality rate to more than 30% (8). In addition to increasing mortality, these infections also prolong hospitalization and increase treatment costs (9). Also, patients hospitalized in special departments are more at risk of hospital infection than other patients due to the presence of risk factors such as multiple injuries, low level of consciousness and weak preventive mechanisms (8, 10). Every year, about 20% of special beds are occupied by patients caused by hospital infections. These parts are the main center of emergence of resistant microbes and antibiotic resistance, so special attention to these parts seems more necessary (11). 
    Since infection is the main cause of infant mortality in developing countries (12) and in the last century, due to the advancement of infertility treatment technology, the number of multiples and premature babies resulting from infertility treatment has increased especially in developing countries (13) and due to the fact that premature babies hospitalized in special neonatal units are prone to infection due to their immature immune system (14, 15) and suffering from this Infections cause an increase in mortality and morbidity in these infants, so the control and prevention of hospital infection in these departments also requires special attention (16).
    Given the high risks and importance of dealing with hospital infections, it is necessary that all medical personnel do their best in order to reduce its rate by acquiring the knowledge of identifying, preventing, controlling hospital infections and strengthening beliefs in order to raise the level of community health and change group behavior by preparing a comprehensive infection control program in hospitals (17).
     
     
    Currently, the best, most effective and least expensive method of prevention is following the recommendations of the Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO) regarding the prevention and control of infection, observing hand hygiene, especially washing hands before and after contact with each baby (6, 18) and the impact of hand hygiene on reducing hospital infections by many studies It has been confirmed (19-21) and it is possible to reduce hospital infections by 50% by washing hands (22).
    It is necessary for healthcare providers to disinfect their hands before starting the clinical examination, after the examination, before putting on gloves and after removing the gloves, and in between examinations of patients with the correct technique and with soap and water or with special alcohol solutions. Despite the necessity of using gloves in certain cases, they cannot replace hand washing because when removing the gloves, the hands may be contaminated again and this contamination may be transferred to the health care provider or the next patient(7). 
    Referring to many clinical, experimental and epidemiological studies, it is recommended to observe hand hygiene in the absence of obvious contamination with blood and secretions, through disinfectant solutions and by the Hand rub method (rubbing the hands with a disinfectant) and in case of contamination with blood and secretions, strict washing with soap and water, observing the appropriate time(23). 
    Washing hands is very necessary for the care or examination of infants, and because this age group is more vulnerable, it is more important when examining infants, especially infants who are hospitalized in the special wards for infants. because the younger the person's age, the more likely he is vulnerable, just as the highest probability of death is in the first 24 hours of a person's life, the first week, and the following times respectively, and this indicates the high vulnerability of people at a young age and infancy, and in order to promote the culture of hand washing or hand hygiene, patients or parents of infants should ensure that their hand hygiene is observed by their medical team before examination and examination by the medical team by asking a simple question(7).
    While hospital infections are a serious problem in healthcare centers, researches in the country show that in the most optimistic case, only 40% of healthcare providers fully observe hand hygiene (17).
    The techniques of observing hand hygiene are very simple, but the issue of observing hand hygiene by individuals is very challenging, which is in the results of numerous researches. has been reflected (12, 21, 24, 25) and despite many efforts to develop specific hand hygiene guidelines and the high importance of hand hygiene in preventing hospital infections, researches show that the acceptance of health personnel for hand washing has been small (12, 21, 24, 26).

  • Contents & References of Nurses' views on individual and organizational barriers to hand hygiene in Tabriz neonatal wards, 2013

    List:

    The first chapter: Research introduction

    Research title

    Research field

    Research objectives

    General objective

    Specific objectives

    Sub-objective

    Application objective

    Research questions

    Presuppositions

    Definition of specific words

    Source:

    References

     

    1.         Morrison LG, Yardley L. What infection control measures will people carry out to reduce transmission of pandemic influenza? A focus group study. BMC Public Health. 2009;9(1):258.

    2.         Longtin Y, Sax H, Allegranzi B, Schneider F, Pittet D. Hand hygiene. New England Journal of Medicine. 2011;364(13).

    3.         Who. Report on the burden of endemic health care-associated infection worldwide. 2011.

    4.         Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 2011;377(9761):228-41.

    5.         http://www.isna.ir/fa/news/92091208484. 2013.

    6.         Park HY, Kim SK, Lim YJ, Kwak SH, Hong MJ, Mun HM, et al.  Assessment of the appropriateness of hand surface coverage for health care workers according to World Health Organization hand hygiene guidelines.  Am J Infect Control 2014; 42(5):559-617.

    7.         http://www.isna.ir/fa/news/92101306292. 2014.

    8.         Orsi G, Scorzolini L, Franchi C, Mondillo V, Rosa G, Venditti M. Hospital-acquired infection surveillance in a neurosurgical intensive care unit. Journal of Hospital Infection. 2006;64(1):23-9.

    9.         Ajalloeyan M, Kazemi H, Samar G, Fazzade A. Rate and effective factor of infection in ICU of Khatamolanbia Hospital. J Goum. 2007;2(22):34-8.

    10.       Nazari R, Haji Ahmadi M, Dadashzade M, Asgari P. Study of hand hygiene behavior among nurses in critical care units.  Iranian Journal of Critical Care Nursing 2011; 4 (2): 95-8

    11.       Sayedolshohadaei SA, Khairollahi S, Afkhamzadeh A. Comparison of efficacy of hand washing with Betadin and Sterillium on bacterial colony count in intensive care unit personnel. Scientific Journal of Kurdistan University of Medical Sciences. 2009;13(4):1-8.

    12.       Huis A, Hulscher M, Adang E, Grol R, van Achterberg T, Schoonhoven L. Cost-effectiveness of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: a cluster randomized trial. International journal of nursing studies. 2012.

    13.       Polin RA, Denson S, Brady MT, Papile L-A, Baley JE, Carlo WA, et al. Strategies for prevention of health care-associated infections in the NICU. Pediatrics. 2012;129(4):e1085-e93.

    14.       Verklan MT, Walden M. Core curriculum for neonatal intensive care nursing: WB Saunders Co; 2010.

    15.       Brady MT. Health care-associated infections in the neonatal intensive care unit. American journal of infection control. 2005;33(5):268-75.

    16.       Fanaroff AA, Martin RJ. Neonatal-perinatal medicine: diseases of the fetus and infant. 1987.

    17.       http://www.isna.ir/fa/news/91110704388. 2012.

    18.       Sharma V, Dutta S, Taneja N, Narang A. Comparing Hand-hygiene Measures in a Neonatal ICU: A Randomized Cross-over Trial. Indian pediatrics. 2013.

    19.       Aragon D, Sole ML, Brown S. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices. AACN Advanced Critical Care. 2005;16(2):121-32.

    20.       Lebovic G, Siddiqui N, Muller M. Predictors of hand hygiene compliance in the era of alcohol-based hand rinse. Journal of Hospital Infection. 2013.

    21.       Baloochi Beydokhti T, Gharceh M, Bahri N, Basirimoghadam K. Baloochi Beydokhti T GM, Bahri N, Basirimoghadam K. The comparison   The comparison of hand hygiene compliance of alcohol-based solution and soap in nurses in Gonabad hospitals during 2009. Ofogh-e-Danesh 2010: 16 (3): 64-70. 22.       Hatami H, Razavi S, Eftekhar A, Majlesi F, Sayed Nozadi M, Parizadeh S. Textbook of public health. Tehran: Arjmand. 2004;3(1):1030-40.

    23.       WHO guidelines on hand hygiene in health care: first global patient safety challenge. Clean care is safer care: World Health Organization; 2009.

    24.       Scheithauer S, Haefner H, Schwanz T, Schulze-Steinen H, Schiefer J, Koch A, et al. Compliance with hand hygiene on surgical, medical, and neurological intensive care units: direct observation versus calculated disinfectant usage. American journal of infection control. 2009;37(10):835-41.

    25.       Shapey I, Foster M, Whitehouse T, Jumaa P, Bion J. Central venous catheter-related bloodstream infections: improving post-insertion catheter care. Journal of Hospital Infection. 2009;71(2):117-22.

    26.       Allegranzi B, Pittet D. Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection. 2009;73(4):305-15.

    27.       Efstathiou G, Papastavrou E, Raftopoulos V, Merkouris A. Factors influencing nurses' compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study. BMC nursing. 2011;10(1):1.

    28.       McGuckin M, Waterman R, Govednik J. Hand Hygiene Compliance Rates in the United States—A One-Year Multicenter Collaborative Using Product/Volume Usage Measurement and Feedback. American Journal of Medical Quality. 2009.

    29.       Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infection Control and Hospital Epidemiology. 2010;31(3):283-94.

    30.       van Beeck E, Daha T, Richardus J, Vos M. 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. Infection control and hospital epidemiology. 2009;30(5):415-9.

     

    31.       Whitby M, McLaws ML, Ross MW. Why healthcare workers don't wash their hands: a behavioral explanation. Infection Control and Hospital Epidemiology. 2006;27(5):484-92.

    32.       Samadipour E DM, Salari M. Hand hygiene practice in sabzevar hospitals iran. Journal of Sabzevar University of Medical Sciences. 2008; ;15(1):.59-64.

    33.       Massaar E. Improving adherence to hand hygiene practice in a neonatal unit: The effectiveness of an intervention. 2011.

    34.       Zandiyeh M, Borzo R. The level of hand hygiene compliance by operating room personnel of educational hospitals in Hamadan university of medical science. holistic nursing and midwifery the journal of nursing and midwifery faculties Guilan medical university. 2012.

    35.       Jalali R, Tavakoul Kh. Investigating the effectiveness of training on the quality of hand washing in ICU staff in some Kermanshah selected hospitals (1997). behbood. 2000.

    36.       Larson E. A tool to assess barriers to adherence to hand hygiene guidelines. American journal of infection control. 2004;32(1):48-51.

    37.       Muhammad Salman Ashraf M, Syed Wasif Hussain M, Agarwal N, Ashraf S, Gabriel EK, Hussain R, et al. Hand Hygiene in Long-Term Care Facilities: A Multicenter Study of Knowledge, Attitudes, Practices, and Barriers. Hand. 2010;31(7):758-62.

    38.       Scheithauer S, Eitner F, Mankartz J, Haefner H, Nowicki K, Floege J, et al. Improving hand hygiene compliance rates in the hemodialysis setting: more than just more hand rubs. Nephrology Dialysis Transplantation. 2012;27(2):766-70.

    39.       Devnani M, Kumar R, Sharma RK, Gupta AK

Nurses' views on individual and organizational barriers to hand hygiene in Tabriz neonatal wards, 2013
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