An Indirect Method of Assessment of Hand Hygiene: Simple, Easy and Fairly Predictive

摘要

Healthcare associated infections (HCAIs) are of major concern in modern days even though there is significant advancement in medical care and life support system. HCAIs lead to prolonged hospital stay, increased development of resistant microorganisms to antimicrobials, additional financial burden for patients, increased mortality and other resources. Although the risk of acquiring HCAIs is universal and affects every health-care facility and system around the world, the global burden is unknown because of the difficulty of gathering reliable diagnostic data. Overall estimates indicate that more than 1.4 million patients worldwide are affected at any time.1 In developed countries, HCAIs concerns 5–15% of hospitalized patients and 9–37% of those admitted to intensive care units (ICUs).1,2 Mortality due to HCAIs in Europe is estimated to be 1% (50 000 deaths per year), but HCAIs contributes to death worldwide in at least 2.7% of cases (135 000 deaths per year). The estimated HCAIs incidence rate in the USA was 4.5% in 2002, corresponding to 9.3 infections per 1000 patient-days and 1.7 million affected patients; approximately 99,000 deaths were attributed to HCAIs.3 The importance of hand hygiene in preventing health care associated infections has been well known since the study carried out by Semmelweis in 1884.4 For generations, hand washing with soap and water has been considered a measure of personal hygiene. Hand-hygiene promotion has been challenging for >150 years. There is a temporal relationship between improved hand-hygiene practices and reduced infection rates. We have very little data available on hand hygiene practices among healthcare personnel in India. Hand hygiene performance in health care can be monitored directly or indirectly. Direct methods include direct observation, patient assessment or HCW self-reporting. Indirect methods include monitoring consumption of products, such as soap or handrub, and automated monitoring of the use of sinks and handrub dispensers.