An evaluation of hospital hand hygiene practice and glove use in Hong Kong.

Chau, Janita P-C; Thompson, David R; Twinn, Sheila; Lee, Diana T F; Pang, Sharon W M

AIM To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong. BACKGROUND Hospital-acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low. DESIGN An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit. METHODS Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed. RESULTS The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74.7% and with glove use 72.4%. In approximately two-third of episodes, participants washed their hands after each patient contact; though, 78.5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28.6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non-intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤ 5, 6-10, >10 years. RELEVANCE TO CLINICAL PRACTICE Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed.