The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

THE PRACTICE OF HANDWASHING AND USING GLOVES CAN BE IMPROVED AMONG RESPIRATORY CARE PRACTITIONERS (RCP) IN THE INTENSIVE CARE UNIT (ICU).

Mohamad Khatib^{a}, Afif Abdallah^{a}, Youssef Ibrahim^{a}, and Ghassan Jamaleddine^{b}. American University of Beirut, ^{a}Dept. of Anesthesiology and ^{b}Medicine, Beirut, Lebanon.

INTRODUCTION: Health care providers are primary pathways for transmission of pathogens among patients in hospitals. Appropriate handwashing techniques and the use of protective aids (e.g., gloves and masks) are necessary to improve infection control. Unfortunately these techniques and tools are either not practiced appropriately or forgotten by the caregivers. The purpose of this study is to evaluate the effectiveness of warning labels permanently attached to the ventilators in improving handwashing and use of gloves by RCPs in the ICU. Methods: The study consisted of two four weeks periods. Daily observations of handwashing and use of gloves by RCPs were made over four one hour observation periods (two on day shift and two on evening shift). Prior to the first 4 weeks period, inservice lectures on handwashing techniques and use of gloves were given to all shifts. At the end of the first period, "WASH HANDS & USE GLOVES" labels were permanently placed on all ventilators. RCPs were not aware they were being observed for handwashing and use of gloves in either period. The Wilcoxon rank sum test was used for statistical analysis. Results: Data are presented in Tables 1 & 2 for the two periods.

A: # Handwash before encounter C: Wear gloves before encounter

B: # Handwash after encounter D: Take off gloves after encounter

Table 1: First 4 weeks period (no labels)

# of encounters Handwashing Gloves

A (%) B (%) C (%) D (%)

1st Week 142 111(78%) 131(92%) 79(56%) 79(100%)

2nd Week 129 62(48%) 99(77%) 48(37%) 48(100%)

3rd Week 134 36(27%) 114(85%) 43(32%) 43(100%)

4th Week 132 38(29%) 103(78%) 59(45%) 59(100%)

Total 537 247(46%) 447(83%) 229(43%) 229(100%)

Table 2: Second 4 weeks period (with labels) * p < 0.05 vs. Table 1

A (%) B (%) C (%) D (%)

1st Week 149 140(94%)* 140(94%) 140(94%)* 140(100%)

2nd Week 143 126(88%)* 129(90%)* 126(88%)* 126(100%)

3rd Week 127 121(95%)* 121(95%)* 121(95%)* 121(100%)

4th Week 124 115(92%)* 115(92%)* 115(92%)* 115(100%)

Total 543 502(92%)* 505(93%) 502(92%)* 502(100%)

Rates of handwashing and use of gloves were significantly higher during the second period when labels were attached to the ventilators. During the first period the rates of handwashing and use of gloves were declining over time which was not observed during the second period. CONCLUSION: Simple measures such as placement of reminding labels on mechanical ventilators can significantly improve handwashing and use of gloves practice by RCPs in the ICU. This should help in minimizing and limiting the transmission of pathogens via health caregivers and thus improve infection control in hospitals.

OF-97-140

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