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Impact of a simulation-based training in hand hygiene with alcohol-based hand rub in emergency departments

Published online by Cambridge University Press:  15 October 2018

Aiham Daniel Ghazali Open the ORCID record for Aiham Daniel Ghazali [Opens in a new window] ,
Elsa Deilhes ,
Julie Thomas ,
Catherine Laland ,
Sarah Thévenot ,
Jean Pierre Richer  and
Denis Oriot
Aiham Daniel Ghazali*
Affiliation:
Simulation Center, University of Paris-Diderot, Paris, France Emergency Department and EMS, University Hospital of Bichat, Paris, France
Elsa Deilhes
Affiliation:
Pediatric Department, Hospital of Niort, France
Julie Thomas
Affiliation:
Emergency Department, University Hospital of Poitiers, Poitiers, France
Catherine Laland
Affiliation:
Hygiene Department, University Hospital of Poitiers, Poitiers, France
Sarah Thévenot
Affiliation:
Hygiene Department, University Hospital of Poitiers, Poitiers, France
Jean Pierre Richer
Affiliation:
Anatomy and Simulation Laboratory, University of Poitiers, Poitiers, France
Denis Oriot
Affiliation:
Anatomy and Simulation Laboratory, University of Poitiers, Poitiers, France Pediatric Emergency Department, University Hospital of Poitiers, Poitiers, France
*
Author for correspondence: Dr Daniel Aiham Ghazali MD, PhD, Emergency Department and EMS, University Hospital of Bichat, 46 rue Henri Huchard, 75018 Paris, France and Simulation Center, University Paris Diderot, 20 rue du Département, 75018 Paris, France. E-mail: aiham@hotmail.com
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Abstract

Background

Hand hygiene is the primary measure for reducing nosocomial infections based on 7 steps recommended by the WHO. The aim of this study was to assess the duration and the quality of hand hygiene before and after simulation-based training (SBT).

Methods

The study took place in a University Hospital Pediatric Department among its residents and nurses. In assessment A, 10 hand-rubbing procedures per participant during a work day were scored by observers using a validated, anatomically based assessment scale. Two weeks later, all participants received a didactic course and SBT, followed 1 month later by assessment B, observation of 10 hand-rubbing procedures. Assessments were performed by 2 independent observers. Before-and-after testing was used to evaluate the demonstration of theoretical knowledge.

Results

In total, 22 participants were included, for whom 438 hand hygiene procedures were assessed: 218 for assessment A and 220 for assessment B. The duration of hand rubbing increased from 31.16 seconds in assessment A to 35.75 seconds in assessment B (P=.04). In assessment A, participants averaged 6.33 steps, and in assessment B, participants averaged 6.03 steps (difference not significant). Significant improvement in scores was observed between assessments A and B, except for the dorsal side of the right hand. The wrist and interdigital areas were the least-cleaned zones. A difference between assessments A and B was observed for nail varnish (P=.003) but not for long nails or jewelry. Theoretical scores increased from 2.83 to 4.29 (scale of 0–5; P<.001).

Conclusion

This study revealed that an optimal number of steps were performed during hand-rubbing procedures and that SBT improved the duration and quality of hand hygiene, except for the dorsal right side. Emphasis should be placed on the specific hand areas that remained unclean after regular hand-rubbing procedures.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 11 , November 2018 , pp. 1347 - 1352
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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