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Patterns of Handwashing Behavior and Visits to Patients on a General Medical Ward of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Janet Raboud ,
Refik Saskin ,
Kurt Wong ,
Christine Moore ,
Grace Parucha ,
Jocelyn Bennett ,
Karen Green ,
Don Low ,
Mark Loeb  and
Andy Simor
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Janet Raboud*
Affiliation:
Department of Public Health Sciences, University of Toronto and the University Health Network, Toronto, Ontario, Canada
Refik Saskin
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Kurt Wong
Affiliation:
Faculty of Science, University of Toronto, Toronto, Ontario, Canada
Christine Moore
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Grace Parucha
Affiliation:
Department of Nursing, Mount Sinai Hospital, Toronto, Ontario, Canada
Jocelyn Bennett
Affiliation:
Department of Nursing, Mount Sinai Hospital, Toronto, Ontario, Canada
Karen Green
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Don Low
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
Mark Loeb
Affiliation:
McMaster University, Hamilton, Ontario, Canada
Andy Simor
Affiliation:
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada
Allison McGeer
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
*
Prosserman Center for Health Research, Room 5-244, 60 Murray St., Toronto, Ontario M5G 1X5, Canada
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Abstract

Objective:

To obtain accurate data regarding the handwashing behavior and patterns of visits to patients by healthcare workers (HCWs).

Methods:

All visits by HCWs to selected patient rooms were recorded for 3 days and 2 nights. Additionally, 5 nurses were observed for 1 day each and 2 nurses were observed for 1 night each. Nurses were observed for their entire shifts and all of their activities were recorded.

Setting:

A general medical ward in a tertiary-care hospital.

Participants:

Convenience samples of HCWs and patients.

Results:

Patients were visited every 25 minutes on average. Monitoring rooms and observing nurses resulted in similar rates of patient visits. The highest level of risk was contact with body fluids in 11% of visits and skin in 40% of visits. The overall rate of handwashing was 46%; however, the rate was higher for visits involving contact with body fluids (81%) and skin (61%). Nurses returned immediately to the same patient 45% of the time. The rate of handwashing was higher for the last of a series of visits to a patient's room (53% vs 30%, P < .0001).

Conclusions:

Nurses adjusted their handwashing rates in accordance with the risk level of each visit. Monitoring patient rooms and observing nurses yielded similar estimates of patient visits and proportions of visits involving contact with skin or body fluids. Education programs about hand hygiene may be more effective if patterns of care and levels of risk are incorporated into recommendations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 3 , March 2004 , pp. 198 - 202
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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