Compliance with hand-hygiene guidelines among healthcare workers: a cross-sectional study at the Umberto I teaching hospital of Rome, Italy

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Abstract

Introduction. Healthcare-associated infections are often associated with poor hand hygiene
(HH) by healthcare workers (HCWs). The objective of this cross-sectional study at the Umberto I teaching hospital in Rome was to quantify compliance with HH by direct observation following a multimodal strategy devised by the World Health Organisation and to map critical areas for improvement.
Methods. Predictors of HH compliance were identified using a multivariable logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.
Results. Eighty-four trained observers from 50 wards collected 4,081 observations showing
that overall HH compliance was 71.9%. The multivariable analysis found a positive association with the outcome for midwives compared to physicians (aOR=2.5, 95% CI: 1.5-4.1), and a negative association for healthcare assistants (aOR=0.5, 95% CI: 0.3- 0.8). There was greater compliance during public holidays and weekends (aOR=1.5, 95% CI: 1.1-2.1), but compliance was lower for external staff (aOR=0.7, 95% CI: 0.5-0.9). We   found a positive association with all HH indications after interaction with a patient or with patient surroundings compared with the indication “before touching a patient” (all p<0.001); the highest association was with the indication “after contact with biological fluids” (aOR=7.7, 95% CI: 4.7-12.5).
Conclusion. Overall, we observed reasonable compliance levels, but it is important to
increase adherence to HH practice and monitor any behaviour change.

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Authors

Martina Antinozzi - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy https://orcid.org/0000-0002-8898-1004

Mariateresa Ceparano - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Vincenzo Cammalleri - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Valentina Baccolini - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Daniela Tufi - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Maria De Giusti - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Paolo Villari - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Carolina Marzuillo - Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

How to Cite
Antinozzi, M., Ceparano, M., Cammalleri, V., Baccolini, V., Tufi, D., De Giusti, M., … Marzuillo, C. (2023). Compliance with hand-hygiene guidelines among healthcare workers: a cross-sectional study at the Umberto I teaching hospital of Rome, Italy. Annali dell’Istituto Superiore Di Sanità, 59(3), 204–212. https://doi.org/10.4415/ANN_23_03_06
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