1996 OPEN FORUM Abstracts
RESPIRATORY THERAPISTS' HANDWASHING PRACTICES IN MEDICAL INTENSIVE CARE UNIT: AN OBSERVATIONAL STUDY.
Kulow K RRT, Stoller JK MD, Cleveland Clinic Foundation, Cleveland, Ohio
Background The hands of a caregiver can easily act as a vehicle to transmit pathogens from one patient to another. In an effort to both evaluate and improve infection control in the Medical Intensive Care Unit (MICU) of the Cleveland Clinic Foundation, a study observing handwashing practices and use of gloves was performed. Methods: The study consisted of six two hour observation periods (three on day shift and three on evening shift), during which the staff was unaware they were being observed regarding handwashing and use of gloves while performing routine patient care. Results: Handwashing prior to patient contact was observed with 17% of respiratory care practitioners (RCPs), 6% of nurses, and 0% of physicians. Overall, for 111 separate patient encounters, handwashing was practiced before the encounter in 10% of instances. After patient contact, rates of handwashing were 43% for RCPs, 26% for nurses and 20% for physicians. At the conclusion of the study, the total rate of handwashing after the patient encounter was 32%. Donning gloves was practiced by all 21 RCPs observed (100%), but only 13 (72%) removed their gloves after completing the patient encounter. These observations suggests that handwashing was infrequently practiced during routine patient care in the MICU. Although use of gloves was more commonly observed, providers frequently failed to change gloves between patients. To improve handwashing and glove practices, several measures were undertaken: 1. In service lectures were delivered to all shifts regarding the study findings and current handwashing guidelines, 2. Permanent labels were place on every ventilator in the MICU to remind each therapist to wash hands, 3. A summary of the observational study findings was distributed to each respiratory therapist in the MICU, along with several journal articles regarding infection control and the importance of handwashing. Conclusion: With the goal to assure complete compliance with handwashing practices, a follow up study is planned as an ongoing monitoring activity.