Hand hygiene practices among health care workers in the Kenyatta National Hospital newborn unit

Abstract

Previous studies conducted in the Kenyatta National Hospital (KNH) Newborn Unit (NBU) reported high prevalence rates of neonatal sepsis, an important contributor to the high neonatal mortality rate. Hand hygiene is the most effective measure of preventing healthcare-associated infections. No study has been done to evaluate the hand hygiene practices of health care workers (Hf'Ws) in this unit.

Objectives The objectives of this study were; to determine the hand hygiene practices among HCWs in the KNH NBU, to assess their knowledge and perceptions regarding HCAls, and to assess barriers to the recommended hand hygiene practices.

Methodology A descriptive cross-sectional study. HCWs were observed unobtrusively using the WHO 'five moments for hand hygiene' observation tool. A questionnaire was then administered to meet the secondary objectives.

Results A total of 312 hand hygiene opportunities were observed in 83 HCW sand 81 questionnaires administered. The overall average hand hygiene compliance rate was 15% (47/312). Doctors had the highest compliance rate of 25.7% (19/74). Nurses and nursing students had statistically significant lower compliance compared to the doctors (OR=0.41; 95% CI=0.18-0.9I; p=0.OI6) and (OR=0.21; 95% CI=0.06-0.70; p=0.004) respectively. HCWs were more likely to take a hand hygiene action after an activity than before (OR=2.05; 95% Cl'cl.02-4.19; p '=0.03). 52% of the HCWs were unaware of the five moments of hand hygiene. Lack of supplies, forgetfulness and use of gloves were the commonly reported barriers to hand hygiene compliance.

Recommendations Training of HCWs, availing hand hygiene supplies and reinforcement of hand hygiene reminders are recommended.