Compliance with hand-hygiene guidelines among healthcare workers: a cross-sectional study at the Umberto I teaching hospital of Rome, Italy
Authors
Martina Antinozzi, Mariateresa Ceparano, Vincenzo Cammalleri, Valentina Baccolini, Daniela Tufi, Maria De Giusti, Paolo Villari, Carolina Marzuillo
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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