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Scientific article
English

Hand-cleansing during postanesthesia care

Contributors

Pittet, Didier; Stephan, Francois; Hugonnet, Stéphane; Akakpo, Christophe; Souweine, Bertrand; Clergue, François

Published in

Anesthesiology, vol. 99, no. 3, p. 530-535

Publication date

2003

Abstract

BACKGROUND: Transmission of microorganisms from the hands of healthcare workers is the main source of cross-infection and can be prevented by hand-cleansing. The authors assessed the compliance rate with hand-cleansing practices in the postanesthesia care unit and investigated factors associated with noncompliance. METHODS: Patient care activities, indications for and compliance of postanesthesia care unit staff with hand-cleansing, defined as either washing hands with soap and water or rubbing hands with alcohol, were monitored at the time of patient admission and during their stay. Multivariate analysis identified predictors of noncompliance with hand-cleansing on admission after adjustment for confounders. RESULTS: A total of 3,143 patient care activities, including 1,091 opportunities for hand-cleansing at high or medium risk for cross-transmission, were recorded among 187 patients. The higher the workload, the higher the number of indications for hand-cleansing and the lower the compliance. Average compliance with hand-cleansing at postanesthesia care unit admission was 19.6%. Independent predictors for noncompliance included caring for patients older than 65 yr (odds ratio, 2.23; 95% confidence interval, 1.40-3.57) and those recovering from clean/clean-contaminated surgery (odds ratio, 2.27; 95% confidence interval, 1.11-4.76), as well as high intensity of patient care (odds ratio, 1.01 per patient care activity; 95% confidence interval, 1.0-1.02). Compliance with hand-cleansing for patients already admitted to the postanesthesia care unit was 12.5%. CONCLUSIONS: Failure to cleanse hands during patient care is common in the postanesthesia care unit and is associated with identifiable factors. The close relation between the intensity of patient care and noncompliance argues that hand-cleansing should not be viewed as a problematic individual behavior only, and system change must be considered in prevention strategies.

Keywords

  • Adult
  • Aged
  • Cross Infection/prevention & control
  • Female
  • Guideline Adherence
  • Hand/ microbiology
  • Humans
  • Hygiene/ standards
  • Male
  • Middle Aged
  • Postanesthesia Nursing/standards
  • Recovery Room/ standards

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

PITTET, Didier et al. Hand-cleansing during postanesthesia care. In: Anesthesiology, 2003, vol. 99, n° 3, p. 530–535. doi: 10.1097/00000542-200309000-00006

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Additional URL for this publication

http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00000542-200309000-00006&LSLINK=80&D=ovft

Journal ISSN

0003-3022
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Technical informations

Creation

21/06/2010 10:25:59

First validation

21/06/2010 10:25:59

Update

14/03/2023 15:45:10

Status update

14/03/2023 15:45:10

Last indexation

29/10/2024 15:17:18
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