Hand Hygiene Practices among Nurses in South Sulawesi Hospitals
Abstract
Healthcare professionals’ adherence to hand hygiene protocols is paramount to prevent Healthcare-Associated Infections (HAIs) and ensure patient safety. This study evaluates compliance with the World Health Organization's (WHO) "Five-Moment Hand Hygiene" protocol among nurses in two Indonesian hospitals: Regional General Hospital X in Makassar City and Provincial General Hospital Y in South Sulawesi Province. A total of 60 nurses participated, with demographic analysis revealing significant differences between the hospitals. Utilizing a comprehensive observation tool provided by the WHO, data analysis indicated variations in hand hygiene practices, particularly after touching patient surroundings. Despite these differences, the data followed a normal distribution, enhancing the reliability of statistical analyses. Significant disparities in hand hygiene practices were found after touching patient surroundings (p-value = 0.008; α < 0.05), underscoring the urgent need for targeted interventions among nurses to improve their compliance and enhance patient safety. This study recommends comprehensive training, resource provision, regular audits, fostering a supportive organizational culture, and integrating robust hand hygiene modules into nursing education. The study also suggests further research to identify barriers and improvement strategies. Addressing these recommendations collectively will bolster patient safety and reduce healthcare-associated infection burdens in Indonesian healthcare settings. The study's identification of specific deficiencies in hand hygiene practices provides actionable insights for healthcare administrators, infection control practitioners, and frontline healthcare workers, emphasizing the urgency of sustained efforts to promote proper hand hygiene practices.
References
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20. Ben Fredj S, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Dhidah L, et al. Multimodal Intervention Program to Improve Hand Hygiene Compliance: Effectiveness and Challenges. Journal of the Egyptian Public Health Association. 2020;95(1):1-8. https://doi.org/10.1186/s42506-020-00039-w
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22. Kuipers SJ, Cramm JM, Nieboer AP. The Importance of Patient-centered Care and Co-creation of Care for Satisfaction with Care and Physical and Social Well-being of Patients with Multi-morbidity in the Primary Care Setting. BMC Health Service Research. 2019;19(13):1-9. https://doi.org/10.1186/s12913-018-3818-y
23. Magadze TA, Nkhwashu TE, Moloko SM, Chetty D. The Impediments of Implementing Infection Prevention Control in Public Hospitals: Nurses’ perspectives. Health SA Gesondheid. 2022;27:1-8. https://doi.org/10.4102%2Fhsag.v27i0.2033
24. Soboksa NE, Negassa B, Kanno G, Ashuro Z, Gudeta D. Hand Hygiene Compliance and Associated Factors among Healthcare Workers in Ethiopia: A Systematic Review and Meta-Analysis. Advances in Preventive Medicine. 2021;2021:1–10.
https://doi.org/10.1155/2021/7235248
25. Smith S, Johnson G. A Systematic Review of the Barriers, Enablers and Strategies to Embedding Translational Research within the Public Hospital System Focusing on Nursing and Allied Health Professions. PLoS One. 2023;18(2):1-22.
https://doi.org/10.1371/journal.pone.0281819
2. Tacconelli E. Linking Infection Control to Clinical Management of Infections to Overcome Antimicrobial Resistance. Journal of Hospital Infection. 2021;114:1–9. https://doi.org/10.1016/j.jhin.2021.04.030
3. Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, et al. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Management and Healthcare Policy. 2020;13:1765–1780. https://www.tandfonline.com/doi/epdf/10.2147/RMHP.S269315?needAccess=true
4. Voidazan S, Albu S, Toth R, Grigorescu B, Rachita A, Moldovan I. Healthcare Associated Infections—A New Pathology in Medical Practice?. International Journal of Environmental Research and Public Health. 2020;17(3):760. https://doi.org/10.3390/ijerph17030760
5. Amaan A, Dey SK, Zahan K. Improvement of Hand Hygiene Practices among the Healthcare Workers in A Neonatal Intensive Care Unit. Canadian Journal of Infectious Diseases and Medical Microbiology. 2022;2022:1–7. https://doi.org/10.1155/2022/7688778
6. Hillier MD. Using Effective Hand Hygiene Practice to Prevent and Control Infection. Nursing Standard. 2020;35(5):45–50. https://doi.org/10.7748/ns.2020.e11552
7. Riu SDM, Talibo NAT. Perilaku dan Ketersediaan Fasilitas Rumah Sakit dengan Kepatuhan Perawat Melakukan Hand Hygiene. Jurnal Keperawatan Stikes Kendal. 2021;13(1). https://doi.org/10.32583/keperawatan.v13i1.1074
8. Smith F, Lee K, Binnie-McLeod E, Higgins M, Irvine E, Henderson A, et al. Identifying the World Health Organization’s Fifth Moment for Hand Hygiene: Infection Prevention in the Operating Room. Journal of Infection Prevention. 2020;21(1):28–34. https://doi.org/10.1177/1757177419879996
9. Memon R, Asif M, Khoso AB, Tofique S, Kiran T, Chaudhry N, et al. Recognising Values and Engaging Communities Across Cultures: Towards Developing a Cultural Protocol for Researchers. BMC Med Ethics. 2021;22(1):47. https://doi.org/10.1186/s12910-021-00608-4
10. CDC. Healthcare-Associated Infections (HAI) Progress Report. Atlanta: Centers for Disease Control and Prevention; 2020. https://arpsp.cdc.gov/profile/national-progress/united-states?HAI-SELECT-SIR=haiVAE&HOSPITAL-SELECT-SIR=haiHospital109
11. Harun MGD, Anwar MMU, Sumon SA, Mohona TM, Hassan MZ, Rahman A, et al. Hand Hygiene Compliance and Associated Factors Among Healthcare Workers in Selected Tertiary-care Hospitals in Bangladesh. Journal of Hospital Infection. 2023;139:220–227. https://doi.org/10.1016/j.jhin.2023.07.012
12. Bisbey TM, Kilcullen MP, Thomas EJ, Ottosen MJ, Tsao K, Salas E. Safety Culture: An Integration of Existing Models and a Framework for Understanding Its Development. Human Factors: The Journal of the Human Factors and Ergonomics Society. 2021;63(1):88–110. https://doi.org/10.1177/0018720819868878
13. Roshan R, Feroz AS, Rafique Z, Virani N. Rigorous Hand Hygiene Practices Among Health Care Workers Reduce Hospital-Associated Infections During the COVID-19 Pandemic. Journal of Primary Care & Community Health. 2020;11. https://doi.org/10.1177/2150132720943331
14. Nuckchady DC. Impact of a Multimodal Improvement Strategy to Promote Hand Hygiene at a Hospital in Mauritius. Cureus. 2021; 13(6): e15812. https://doi.org/10.7759%2Fcureus.15812
15. Byrne AL, Baldwin A, Harvey C. Whose Centre is it anyway? Defining Person-centred Care in Nursing: An Integrative Review. PLoS One. 2020;15(3):1-12. https://doi.org/10.1371/journal.pone.0229923
16. Mlambo M, Silén C, McGrath C. Lifelong Learning and Nurses’ Continuing Professional Development, a Metasynthesis of the Literature. BMC Nursing. 2021;20(62):1-13. https://doi.org/10.1186/s12912-021-00579-2
17. Loftus MJ, Guitart C, Tartari E, Stewardson AJ, Amer F, Bellissimo-Rodrigues F, et al. Hand Hygiene in Low- and Middle-income Countries. International Journal of Infectious Diseases. 2019;86:25–30. https://doi.org/10.1016/j.ijid.2019.06.002
18. Tantum LK, Gilstad JR, Horng LM, Tandanpolie AF, Styczynski AR, Letizia AG, et al. Feasibility and Acceptability of A Novel Intervention to Improve Hand Hygiene Behavior in Rural Liberian Health Facilities. Journal of Water, Sanitation and Hygiene for Development. 2023;13(6):403–414. https://doi.org/10.2166/washdev.2023.190
19. Martos-Cabrera MB, Mota-Romero E, Martos-García R, Gómez-Urquiza JL, Suleiman-Martos N, Albendín-García L, et al. Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review. International Journal of Environmental Research and Public Health. 2019;16(17):1-13. https://doi.org/10.3390/ijerph16173039
20. Ben Fredj S, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Dhidah L, et al. Multimodal Intervention Program to Improve Hand Hygiene Compliance: Effectiveness and Challenges. Journal of the Egyptian Public Health Association. 2020;95(1):1-8. https://doi.org/10.1186/s42506-020-00039-w
21. Akuchie C, Deng F, McCormick W, Moore J, Shaw Z, Lonks JR. Practical Considerations in Hospital Infection Prevention. Journal of Brown Hospital Medicine. 2023;2(4). https://doi.org/10.56305/001c.87912
22. Kuipers SJ, Cramm JM, Nieboer AP. The Importance of Patient-centered Care and Co-creation of Care for Satisfaction with Care and Physical and Social Well-being of Patients with Multi-morbidity in the Primary Care Setting. BMC Health Service Research. 2019;19(13):1-9. https://doi.org/10.1186/s12913-018-3818-y
23. Magadze TA, Nkhwashu TE, Moloko SM, Chetty D. The Impediments of Implementing Infection Prevention Control in Public Hospitals: Nurses’ perspectives. Health SA Gesondheid. 2022;27:1-8. https://doi.org/10.4102%2Fhsag.v27i0.2033
24. Soboksa NE, Negassa B, Kanno G, Ashuro Z, Gudeta D. Hand Hygiene Compliance and Associated Factors among Healthcare Workers in Ethiopia: A Systematic Review and Meta-Analysis. Advances in Preventive Medicine. 2021;2021:1–10.
https://doi.org/10.1155/2021/7235248
25. Smith S, Johnson G. A Systematic Review of the Barriers, Enablers and Strategies to Embedding Translational Research within the Public Hospital System Focusing on Nursing and Allied Health Professions. PLoS One. 2023;18(2):1-22.
https://doi.org/10.1371/journal.pone.0281819
Authors
Asfarada, M. R. ., Rachmawaty, R., Setyawati, A. ., & Malik, G. . (2024). Hand Hygiene Practices among Nurses in South Sulawesi Hospitals . Media Kesehatan Masyarakat Indonesia, 20(1), 29-38. https://doi.org/10.30597/mkmi.v20i1.31480
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