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News archive - May 2015

Location, location, location

Location, location, location

Easily-accessible sinks are vital to hand hygiene compliance within healthcare settings, new research has revealed.

A recent study, published in the American Journal of Infection Control, has highlighted the need for improvements in handwashing facilities in order to help prevent outbreaks of C.difficile in hospital and care home environments.

The study, entitled Impact of sink location on hand hygiene compliance for Clostridium difficile infection, identified access to a lack a readily-visible and accessible sinks as a major barrier to hand hygiene compliance.

“Hand hygiene with soap and water after the care of a patient with Clostridium difficile infection is essential to reduce nosocomial transmission in an outbreak situation,” the report states.

“Factors that may pose barriers to user completion of infection prevention measures, such as hand hygiene, are of interest.

“We undertook a quantitative study to evaluate the relationship between sink location and compliance with handwashing among healthcare workers and visitors in a surgical transplant unit.

“We found that placement of two more-easily-visible sinks was associated with improved adherence to handwashing.”

The quantitative study reports that, although there were 36 sinks on the unit before the intervention - all except two in patient rooms - they were generally not used by healthcare workers because of patient clutter, lack of access because of the presence of furniture, or general unfamiliarity with the patient room layout. It found that it was ‘difficult to minimise clutter around the existing sinks’ because of the length of stay of most patients with Clostridium difficile infection. Furthermore, the two hallway sinks were not readily visible from most patient rooms.

As part of the study, two additional sinks were subsequently placed in highly-visible, optimised locations based on workflow. This led to a 22% increase in hand hygiene compliance, from 13% to 35%; and the completion of proper hand hygiene measures after exiting patient rooms improved by 18%. In addition, the number of individuals who failed to perform any hand hygiene measures after being in the rooms of infected patients decreased from 54% to 37%, and the percentage of individuals who failed to perform any hand hygiene before entering patient rooms was reduced by 21%.

The research also noted that the sink closer to the nursing station was within easy range of most of the patient rooms and was the one that was more heavily used.

The study concluded that: “Limitations notwithstanding, healthcare workers on this unit housing severely immunocompromised patients had an increased incidence of handwashing with additional sinks being placed.

“Systems assessment and interventions to reduce systems barriers are essential to improving healthcare worker and visitor compliance with a complex behavioural intervention, such as hand hygiene for the care of a patient with Clostridium difficile infection.”

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