This descriptive study was conducted in a government-owned multidisciplinary tertiary hospital in Umuahia the capital city of Abia State in the South East geopolitical zone of Nigeria. This study was designed to study compliance with hand hygiene with a view of describing compliance with each of the key moments for hand hygiene during routine patient care activity. This approach falls short of describing the most important and critical indications for hand hygiene during the sequence of care.
Several studies on hand hygiene in healthcare setting have simply and broadly described compliance in terms of before and after patient care activity. The “before” moments are aimed at preventing the risk of transmitting pathogens to the patient and from one body site to a sterile site on the same patient while the “after” moments are intended to prevent transmission of pathogens from the patients to the healthcare worker, the healthcare environment, and other patients. According to the ‘five moments’ concept, healthcare workers should perform hand hygiene ‘before touching a patient’, ‘after touching a patient’, ‘before any sterile or aseptic procedure’, ‘after touching patient’s environment’ and ‘after exposure to blood or body fluids’. This is because the hands can be contaminated during the process of care making it possible to transmit pathogens from a colonized to a sterile body site on the same patient. The traditional view is an oversimplification of hand hygiene and practically may not be as effective as the ‘five moments’ approach in preventing HCAI when applied. It represents a shift from the traditional ‘two moments’ view of hand hygiene which emphasizes hand hygiene immediately before and at the end of patient care activity. This concept defines key moments during routine patient care activities when hand hygiene is required to stop transmission of infectious organisms via the hands in healthcare settings. In order to improve compliance with hand hygiene as well as provide a solid basis to understand, teach, monitor and report hand hygiene practice, the World Health Organization (WHO) in collaboration with some patient safety and infection control experts developed a concept referred to as ‘Five Moments for Hand Hygiene’. This further dashes any hope of improving patient safety in an already weak health systems. The implication of this is high prevalence of HCAIs with associated increase in morbidity, mortality and cost of healthcare in a country battling with a high burden of preventable infectious diseases. Studies in Nigeria have also shown that hand hygiene compliance among Nigerian HCWs is very poor. For several decades hand hygiene has been known to be a very simple and effective measure for preventing Healthcare Associated Infections (HCAIs), but compliance with recommended standards for hand hygiene among Healthcare Workers (HCWs) has not been satisfactory globally. The act of hand rubbing with an alcohol-based antiseptic solution or hand washing with soap and water with the aim of reducing or inhibiting the growth of micro-organisms on the hands is referred to as hand hygiene. Therefore hand hygiene compliance before any patient contact should be emphasized. Compliance was higher in the ‘after’ than in the ‘before’ moments for hand hygiene.
It was 9.9%, 33.1% and 16.9% for before touching, after touching and after touching patients’ surrounding respectively.Ĭonclusion: Overall hand hygiene compliance was low. Compliance was highest after exposure to blood/body fluids (67.83%) and lowest before aseptic procedures (3.5%).
Results: A total of 718 opportunities for hand hygiene were observed with an overall compliance of 23.5%. Methodology: In this observational descriptive study, one hundred and fifty four HCWs in five randomly selected wards of a tertiary hospital were covertly observed for compliance with five moments for hand hygiene over a period of two weeks.
Objective: To determine compliance with hand hygiene among healthcare workers based on the ‘five moments’ concept. Although hand hygiene is recognized as the most effective measure for preventing the transmission of infections in healthcare settings compliance with hand hygiene among Healthcare Workers (HCWs) remains unsatisfactory. The concept stipulates that healthcare workers perform hand hygiene before touching and after touching a patient, before sterile or aseptic procedure, after touching patients’ environment and after exposure to blood or body fluids. Background: The concept of ‘Five Moments for Hand Hygiene’ described in the WHO Guidelines on Hand Hygiene in Health Care, defines the key moments when health-care workers should perform hand hygiene in order to break the transmission of infectious organism via the hands.
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