A Study to Assess Hand washing compliance among nursing professionals in General Wards of Pondicherry Institute of Medical Sciences

Ms. Anchal Singh¹, Mrs. Rajalakshmi. R², Dr. Malarvi Zhi S.³, Dr. K. Ravichandran⁴, Dr. Amirtha Santhi S.⁵

¹MSc (N) Student, College of Nursing, Pondicherry Institute of Medical Sciences, Puducherry, India.

²Assistant Professor, Dept of Medical Surgical Nursing, College of Nursing,

Pondicherry Institute of Medical Sciences, Puducherry, India.

³Professor and Head, Dept. of Community Health Nursing, College of Nursing,

Pondicherry Institute of Medical Sciences, Puducherry, India.

⁴Lecturer, Biostatistician, Pondicherry Institute of Medical Sciences, Puducherry, India.

⁵Assistant Professor, Dept of Medical Surgical Nursing, College of Nursing,

Pondicherry Institute of Medical Sciences, Puducherry.

*Corresponding Author E-mail: senthilkumarraji2010@gmail.com

ABSTRACT:

Hand washing is the practice, which keeps the hands free from pathogens or decrease the amount prior to any procedure or touching the patient. Health Care associated infections (HCAIs) are the major cause of morbidity and mortality. Hospital acquired infections posses a very real and serious threat to all who are admitted in hospitals. Evidence based guidelines for Health Care Workers hand hygiene practice exist, but compliance with these are internationally low (Creedon, 2005)¹. The design adopted for the study was Descriptive design. The study was conducted in all the General medical and surgical wards. Census method was used to collect the data. 116 nurses were working in general wards of PIMS out of which 113 nurses participated in the study. Among 113 Nurses, 69.9% (79) had average compliance to hand washing practices, 21.2% (24) had good hand washing practices and 8.8% (10) had poor washing practices and the reasons for non-compliance to hand washing practices. 7.1% said they were too busy, 2.7% just forgot and 1.8% said the materials were not available. The results revealed that compliance to hand washing practices was average among nurses and there is a need to reinforce the use of standard hand washing protocols available in their wards.

KEYWORDS: Hand Washing, Compliance, WHO, Health Care Workers, Hospital Acquired Infections.

INTRODUCTION:

Hand washing with soap and water has been considered as a measure of personal hygiene. Infection caused due to hospital acquired microbes is an evolving problem worldwide. Hand washing is the practice, which keeps the hands free from pathogens or decrease the amount prior to any procedure or touching the patient.¹

The high prevalence of these infections, as high as 19% in developing countries is a challenge to health care providers.² A world wide systematic review found that incidence of health care associated infection ranged from 1.7 to 23.6 per 100 patients in 2013 (Journal of Health and Infection Society, L.N.Huss, Newyork USA). Hand washing therefore is the most important measure to avoid the transmission of harmful germs³.

STATEMENT OF THE PROBLEM:

“A Study to Assess Hand Washing Compliance Among Nursing Professionals In General Wards Of Pondicherry Institute Of Medical Sciences”

OBJECTIVES OF THE STUDY:

1. To assess the hand washing practices among nursing professionals.

2. To identify the reasons for non compliance in hand washing practice among nursing professionals.

3. To associate the compliance to hand washing practices with the background variables.

METHODS:

The design adopted for the study was Descriptive design. The study was conducted in all the General medical and surgical wards. The conceptual framework used in the study was based on Modified Novice to Expert Model by Patricia Benner (1984). Census method was used to collect the data. 116 nurses were working in general wards of PIMS out of which 113 nurses participated in the study. As each staff nurse performed the hand washing technique, the researcher used the WHO Hand Washing Protocol checklist to observe the steps. After the hand washing procedure the participants were given the self administered questionnaire to fill, related on hand washing practices in their wards. The collected data was used to analyze the hand washing compliance among the Nursing Professionals.

RESULTS AND DISCUSSION:

Section A: Distribution of Background Variables of Participants

Table 1: Frequency and Percentage distribution of participants according to the self rating of compliance to hand washing practices n = 113

S. No.	Rate Of Compliance	Frequency No.	%
1.	1 - 10%	4	3.5
2.	11 - 40%	13	11.5
3.	41 - 70%	56	49.6
4.	71-100%	40	35.4

Table 1: shows the self rating Compliance of nurses to hand washing practices. Majority 49.6% (56) of nurses rated their compliance between 41-70%, 35.4% (40) of nurses between 71-100%, 11.5% (13) of nurses between 11-40% and 3.5% (4) nurses rated their compliance between 1-10%.

Section B: Distribution of Participants According to Level of Hand Washing Practices

Table 2: Percentage distribution of participants according to hand washing practices in each observation n=113

S. No.	STEPS FOR HAND WASHING	Observation 1		Observation 2		Observation 3
S. No.	STEPS FOR HAND WASHING	No.	%	No.	%	No.	%
1.	Wet Hands	113	100	113	100	113	100
2.	Apply Soap	109	96.5	112	99.1	112	99.1
3.	Rub Hands Palm to Palm	110	97.3	111	98.2	108	95.6
4.	Palm to Palm with fingers interlaced	103	91.2	106	93.8	105	92.9
5.	Interlace fingers on right hand over left	76	67.3	102	90.3	94	83.2
6.	Back of fingers opposing palms, fingers interlocking	31	27.4	26	23.0	28	24.8
7.	Rotational rubbing of thumb clasped in fingers	66	58.4	66	58.4	61	54.0
8.	Rotational rubbing with clasped fingers in all palm	59	52.2	36	31.9	50	44.2
9.	Rinse hands with water	89	78.8	105	92.9	102	90.3
10.	Dry hands with towel/dryer	65	57.5	63	55.8	55	48.7
11.	Use towel to turn off tap	28	24.8	18	15.9	19	16.8
12.	Time taken (40-60 sec.)	41	36.3	23	20.4	23	20.4

Figure 1: Percentage distribution of participants according to level of hand washing practices in each observation

Figure 1: shows the level of hand washing practices in each observation. In observation 1 57.5% (65) nurses, in observation 2 68.1% (77) nurses and in observation 3 64.6 (73) nurses had average compliance to hand washing practices respectively.

Figure 2: Percentage distribution of participants according to hand washing practices of all the three observations

Figure 2: shows the overall level of hand washing practices. 69.9% (79) had average compliance hand washing practices, 21.2% (24) had good and 8.8% (10) had poor hand washing practices.

Section C: distribution of participant’s accordng to reasons identified for non-compliance to hand washing practices.

Figure 3: Frequency and Percentage distribution of participants according to compliance and non compliance to hand washing practices.the majority 88.5% (100) participants stated that they never forgot to use hand washing practices and 11.6% (13) participants gave reasons for non compliance to hand washing practices

Section D: Distribution of participants according to reasons identified for non-compliance to hand washing practices

Table 3: Percentage distribution of participants according to the reasons for non-compliance to hand Washing Practices.

S. No.	Reasons for Non compliance	Frequency No.	%
1.	Just Forgot	3	2.7
2.	Too busy	8	7.1
3.	Materials not available	2	1.8

Table 3 reveals that, out of 13 the majority 7.1% (8) participants gave reasons that they were too busy, 2.7% (3) said that they just forgot and 1.8% (2) said that materials were not available at a particular moment for hand washing practice.

CONCLUSION:

The present study assessed the hand washing compliance among nursing professionals in general wards. The study findings revealed that majority of nurses had average hand washing compliance. Therefore, the study concludes that there is a need for reinforcement of hand washing practices among nurses in all wards. By implementing WHO hand washing protocol in each ward nosocomial infection can be prevented and nurses will have better compliance to hand washing practices.

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Received on 21.03.2021 Modified on 16.04.2021

Int. J. of Advances in Nur. Management. 2021; 9(3):254-256.

DOI: 10.52711/2454-2652.2021.00058