Introduction: Hand hygiene, the most effective and economical way to prevent the transmission of many bacteria and viruses in healthcare settings, yet, its compliance rate remained unacceptably poor in many countries. Compliance with hand hygiene among healthcare workers increased substantially during outbreak of serious acute respiratory symptoms (SARS) in 2003 but decreased to the baseline after SARS, to improve compliance rate sustainable, many hand hygiene intervention programs have been established since 2003. However, the effectiveness of these programs were in big variations. The objectives of this review were to identify the effectiveness of these hand hygiene intervention programs. Methods: This review was conducted using the search engines – PubMed. The key words “hand hygiene”, “hand-washing”, “compliance”, “healthcare personnel”, and “program*” were used for searching literature published from 2003 to July 2012.. Forty-Seven articles were initially obtained. After screening and reviewing of these articles,9 articles met the requirements for inclusion and exclusion criteria were included in this review. The outcome measure was set as the differences and relative ratios in the observed hand hygiene compliance rate before and after intervention. Results: Results showed that 8 hand hygiene programs were effective while 1 programme was ineffective in improving hand hygiene compliance rates. Of the eight studies that reported improvement in compliance with hand hygiene, improvement in compliance rate after the interventions was ranged from (24% to 50%) while the relative ratio of compliance (after vs. before intervention) was ranged from 1.78 to 4. The study that reported no improvement in compliance with hand hygiene had a relative high naseline hand hygiene compliance rate of 61% Conclusion: Hand hygiene programs that improve compliance rate among healthcare workers were effective overall. The effectiveness of hand hygiene programs seemed to be positively associated with the numbers of intervention types involved. Research on non-compliance and intrapersonal behavior on hand hygiene was suggested for future investigation. / published_or_final_version / Public Health / Master / Master of Public Health

BACKGROUND Influenza is a potential threat to life, economies and security in our globalized world. However, it is still unclear how efficacious non-pharmaceutical interventions are in reducing the virus’ transmission and how the underlying mechanisms of its transmission modes work. Since 2008, numbers of randomized controlled trials (RCTs) regarding the efficacy of hand hygiene interventions in reducing influenza transmission have been published, yet no metaanalysis has ever been performed. Besides, a guinea pig model in 2009 showed that the efficiency of aerosol transmission is adjusted by the ambient temperature and humidity. Therefore, further evidence is needed to confirm the hypothesis. OBJECTIVES To evaluate the efficacy of hand hygiene interventions alone or combined with facemasks in reducing influenza transmission in the community and to investigate the possible roles of latitude, temperature and humidity in relation to the efficacy of the interventions in controlling the spread of influenza. SEARCH METHODS This meta-analysis followed the PRISMA statement. I searched the MEDLINE, PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Library databases. SELECTION CRITERIA I included all RCTs assessing the effect of hand hygiene interventions in preventing influenza spread in community settings with clear outcome definitions of laboratory confirmed influenza, clinically diagnosed influenza-like illness (ILI) and their related absenteeism. DATA COLLECTION AND ANALYSIS I ranked the methodological quality of each outcome with GRADEprofiler. I also assessed the heterogeneity across RCTs using I2 statistic and publication bias through visual inspection of Begg’s funnel plots and statistical assessment of regression and rank-correlation. I conducted the meta-analysis with random-effect models and further performed separate analyses for developed and developing countries data in case of a significant level of heterogeneity being noted across the studies. I also incorporated meta-regression to assess the association of latitude, temperature and humidity with the efficacy of hand hygiene interventions. RESULTS I identified 1,593 articles in the initial database search, excluded 1,535, included five from reference lists of review articles, retrieved full articles of 33 and included ten for analysis. The quality of evidence of both laboratory confirmed influenza and ILI were high while that of absenteeism was low. The combination of hand hygiene interventions and facemasks contributed to a significant 45% reduced risk of influenza-related absenteeism in the combined country data while it contributed a significant 23% to a reduced risk of both laboratory confirmed influenza and ILI in developed countries subgroup analysis. The metaregression revealed that the efficacy of the combination of hand hygiene interventions with facemasks increased in a less humid environment. CONCLUSIONS The combination of hand hygiene interventions with facemasks is an effective low-cost intervention to prevent influenza. Further studies to assess the association between humidity and mode of influenza transmission are critically important to support the international guideline on hand hygiene interventions and facemask use. / published_or_final_version / Public Health / Master / Master of Public Health

Hospital-acquired, or nosocomial infections (HAIs) are the major source of mortality and morbidity for hospitalized patients. It is estimated that 7-10% patients developed HAIs during their hospital stays, with most patients got infected from intensive care units (ICU) [1,2]. Hand hygiene (HH) is recognized as the most easy and effective way to prevent HAIs. However, the observed hand hygiene compliance rates among healthcare workers (HCWs) have been regarded as unacceptably low, especially in ICU [3]. This literature review is to discuss the factors influencing the hand hygiene compliance among HCWs in ICU, in both the individual and institutional level, and suggest which factor was important in both levels. Recommendations in comprehensive approach on hand hygiene practices will also be included. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Public Health / Master / Master of Public Health

Made available in DSpace on 2014-06-11T19:28:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-24Bitstream added on 2014-06-13T20:17:56Z : No. of bitstreams: 1 medrado_mmpm_me_botfm.pdf: 1611180 bytes, checksum: 121cdb16ee5397268171cbf832fd3cd2 (MD5) / As infecções hospitalares estão entre as principais causas de morbidade e mortalidade em ambientes hospitalares e exige uma maior atenção quando em unidade de terapia intensiva neonatal, uma vez que os recém nascidos apresentam maior risco a desenvolver a infecção gerando uma piora do seu estado clínico. A lavagem das mãos ainda é a medida mais fácil, barata e eficaz de se evitar a disseminação de microorganismos entre pacientes em unidades hospitalares. Neste estudo foram observados 37 profissionais de enfermagem (auxiliares de enfermagem, enfermeiros e técnicos de enfermagem) em uma unidade de terapia intensiva neonatal, em relação à lavagem das mãos na realização de procedimentos de sua competência profissional. Após observação foi aplicado check-list relacionado aos fatores dificultadores da adesão à lavagem das mãos e ao cumprimento dos passos da técnica preconizada permitindo ao profissional classificá-las em essencial, facultativa ou desnecessária. Utilizamos o método descritivo a partir de cálculo de freqüência e porcentagem para as questões e associação com o profissional. Obtivemos uma baixa utilização da prática de lavagem das mãos, sendo que quando esta ocorreu, houve apenas a intenção de lavar as mãos, pois não houve realização da técnica preconizada. A ocorrência de intenção em lavar as mãos não diferiu entre procedimentos invasivos e não invasivos. Pode-se observar ainda, que a maior intenção em lavar as mãos ocorreu após a realização de procedimentos. A falta de tempo foi o fator dificultador da adesão à lavagem das mãos mais citado entre os profissionais. Quanto aos passos da técnica de lavagem das mãos, a maioria dos profissionais classificou todas como sendo essenciais para a efetividade da técnica. O resultado sugere a necessidade de propor intervenções... / Hospital infections are among the leading causes of morbidity and mortality in hospital settings and require more care when in neonatal intensive care unit, once the babies have higher risk to develop infection causing a worsening of his condition. Hand washing is still far easier, cheaper and effective to prevent the spread of germs among patients in hospitals. Observed in this study were 37 nurses (nursing assistants, nurses and nursing technicians) in a neonatal intensive care unit in relation to hand washing procedures in carrying out their professional competence. After observation checklist was applied related to factors that complicate the adherence to hand washing and compliance with the steps of the technique advocated allowing the professional to sort them into essential, optional or unnecessary. Using the method described from calculation of frequency and percentage for the questions and with the professional association. We obtained a low utilization of the practice of washing hands, and when this occurred, there were only intended to wash their hands because there was no realization of the proposed technique. The occurrence of intention to wash their hands did not differ between invasive and noninvasive procedures. It can also be observed that the highest intention to wash hands occurred after the procedures. Lack of time was the factor making adherence difficult to hand washing most cited among professionals. On the steps of the technique of washing hands, most of all qualified professionals as essential to effectiveness of the technique. The result suggests the need to propose educational interventions, behavioral and technical professionals to increase compliance in relation to the use of the technique of hand washing... (Complete abstract click electronic access below)

Orientador: Ione Correa / Banca: Maria de Lourdes S. M. Ferreira / Banca: Ednêis de Brito Girardello / Resumo: As infecções hospitalares estão entre as principais causas de morbidade e mortalidade em ambientes hospitalares e exige uma maior atenção quando em unidade de terapia intensiva neonatal, uma vez que os recém nascidos apresentam maior risco a desenvolver a infecção gerando uma piora do seu estado clínico. A lavagem das mãos ainda é a medida mais fácil, barata e eficaz de se evitar a disseminação de microorganismos entre pacientes em unidades hospitalares. Neste estudo foram observados 37 profissionais de enfermagem (auxiliares de enfermagem, enfermeiros e técnicos de enfermagem) em uma unidade de terapia intensiva neonatal, em relação à lavagem das mãos na realização de procedimentos de sua competência profissional. Após observação foi aplicado check-list relacionado aos fatores dificultadores da adesão à lavagem das mãos e ao cumprimento dos passos da técnica preconizada permitindo ao profissional classificá-las em essencial, facultativa ou desnecessária. Utilizamos o método descritivo a partir de cálculo de freqüência e porcentagem para as questões e associação com o profissional. Obtivemos uma baixa utilização da prática de lavagem das mãos, sendo que quando esta ocorreu, houve apenas a intenção de lavar as mãos, pois não houve realização da técnica preconizada. A ocorrência de intenção em lavar as mãos não diferiu entre procedimentos invasivos e não invasivos. Pode-se observar ainda, que a maior intenção em lavar as mãos ocorreu após a realização de procedimentos. A falta de tempo foi o fator dificultador da adesão à lavagem das mãos mais citado entre os profissionais. Quanto aos passos da técnica de lavagem das mãos, a maioria dos profissionais classificou todas como sendo essenciais para a efetividade da técnica. O resultado sugere a necessidade de propor intervenções... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Hospital infections are among the leading causes of morbidity and mortality in hospital settings and require more care when in neonatal intensive care unit, once the babies have higher risk to develop infection causing a worsening of his condition. Hand washing is still far easier, cheaper and effective to prevent the spread of germs among patients in hospitals. Observed in this study were 37 nurses (nursing assistants, nurses and nursing technicians) in a neonatal intensive care unit in relation to hand washing procedures in carrying out their professional competence. After observation checklist was applied related to factors that complicate the adherence to hand washing and compliance with the steps of the technique advocated allowing the professional to sort them into essential, optional or unnecessary. Using the method described from calculation of frequency and percentage for the questions and with the professional association. We obtained a low utilization of the practice of washing hands, and when this occurred, there were only intended to wash their hands because there was no realization of the proposed technique. The occurrence of intention to wash their hands did not differ between invasive and noninvasive procedures. It can also be observed that the highest intention to wash hands occurred after the procedures. Lack of time was the factor making adherence difficult to hand washing most cited among professionals. On the steps of the technique of washing hands, most of all qualified professionals as essential to effectiveness of the technique. The result suggests the need to propose educational interventions, behavioral and technical professionals to increase compliance in relation to the use of the technique of hand washing... (Complete abstract click electronic access below) / Mestre

Thesis(M. Med. (Public Health Medicine)) -- University of Limpopo, 2019 / Background: Health care workers (HCWs) hands are the most common vehicle for the transmission of health care associated infections (HCAIs) between patients and the health care environment. Hand hygiene is regarded as the most important, simplest, and least expensive means of reducing the burden of HCAIs. However, hand hygiene compliance remains low among HCWs. Aim: To assess the level of knowledge, attitude and self-reported practices (KAP) of HCWs on hand hygiene and associated factors. Method: A quantitative, descriptive study using a pre-tested self-administered questionnaire was conducted among HCWs of Pietersburg Hospital. Data collection was carried out between January and February 2018. KAP scores were summarised into means, standard deviations and percentages. Chi-square and Fisher’s exact tests were used to determine association between KAP scores and selected independent variables (gender, age, profession, experience, discipline and training). Results: There were 324 respondents, mostly females (74.3%), <40 years (70.6%) and predominantly nurses (52.4%). Majority had moderate knowledge (79.3%), positive attitude (88.8%) and good practices (87.9%). Respondents had knowledge gaps on HCAIs, WHO “Five (5) moments for hand hygiene” and alcohol based hand rub. Association was found between respondent’s KAP scores and age (p<0.05). Nursing profession was associated with good practices (p=0.000). Knowledge and attitude were associated with years of clinical experience (p<0.05). Positive attitude (p=0.019) and good practices (p=0.000) were associated with training in the last 3 years. No significant relationship was found between KAP and undergraduate training. Conclusion: Most respondents had moderate knowledge, positive attitude and good practices. Respondent’s variety in KAP scores and associated factors indicate that a multimodal, multifaceted improvement approach should be undertaken to address KAP gaps.

The hand is one of the most complex of all of the anatomical structures in the human body. It has been found that hand injuries are among the most frequent injuries that occur to the body, predominantly during industrial activities. It has therefore been concluded that more research is needed into protective factors, such as glove use. The design features of a glove emphasise either protection or performance. There is often a trade-off between increased safety and performance capability when donning gloves. It has been determined that gloves which are fitted and comfortable for the worker may provide the best compromise between protective functions and decreased performance. This investigation aimed to assess the influence of glove fit on the performance attributes of industrial tasks, as well as on the responses of the human operator. Glove fit was analysed as 35 male participants donned three different glove sizes during each test, including a best-fitting glove, a glove one size smaller than best-fitting, and a glove one size larger than best-fitting. For each glove size, gloves of two differing materials were tested, namely nitrile and neoprene. A barehanded condition was also tested, totalling seven gloved/barehanded conditions for each test. The seven conditions were assessed in a laboratory setting in a battery of tests. This consisted of components of task performance, including maximum pulling and pushing force, maximum torque, precision of force, tactility, speed and accuracy and dexterity. The performance responses were recorded, as well as participants’ perceptual responses using the Rating of Perceived Exertion scale, and muscle activity. Six muscles were selected: Flexor Digitorum Superficialis, Flexor Pollicus Longus, Extensor Carpi Ulnaris, Extensor Carpi Radialis, Flexor Carpi Ulnaris and Flexor Carpi Radialis. The results revealed that glove fit does affect certain spects of performance, and influences human operator responses for selected task components. Furthermore, discrepancies were distinguished between orking barehanded and working with an optimally fitted glove. There was also a glove material effect established. Overall, it was found that muscle activity when exerting maximum force in a pushing and pulling direction was optimal with the nitrile glove material. Maximum torque performance was enhanced with the use of a best-fitting glove, as compared with an ill-fitting glove or barehanded work. Force precision was preferable when barehanded, as opposed to the tactility task which rendered optimal results with a best-fitting glove. The same was found for speed and accuracy results, as glove fit appeared to have no effect on performance, but performance was improved when participants were barehanded. Dexterity performance was the most conclusively influenced by the conditions, resulting in barehanded performance being optimal. However, should a glove be necessary for a given task, an optimally-fitted glove which is of a thinner material would be recommended. It is necessary to distinguish the performance components of a task within industry and select the most appropriate glove for optimal performance and the least risk of overexertion.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-07-18T11:44:03Z No. of bitstreams: 1 Regina Silvia Chaves de Lima.pdf: 1502566 bytes, checksum: 13df8f50607c72373833f47cbfb6de16 (MD5) / Made available in DSpace on 2018-07-18T11:44:03Z (GMT). No. of bitstreams: 1 Regina Silvia Chaves de Lima.pdf: 1502566 bytes, checksum: 13df8f50607c72373833f47cbfb6de16 (MD5) Previous issue date: 2018-03-26 / Introduction: Introduction: hand hygiene of health-care workers is the measure with the greatest impact on the effectiveness of prevention and control of infections related to the health-care system. This basic and easily implemented measure has been a worldwide challenge due to its low compliance, despite several strategies made by the World Health Organization. Objectives: the main goal was to evaluate the improvements in hand hygiene of medical students achieved by a DLP. The secondary objectives were to enable medicine students in hand hygiene, to assess hand hygiene training by DLP and to establish a collaboration between the hand hygiene training DLP and the hospital infection control program. Material and method: 99 students of the UNIFEV Medicine course were evaluated through a qualitative and quantitative approach and exploratory methods. The training consisted of six activities, being five online and one on-site. The first was the application of a multiple-choice test with summative evaluation to survey the previous knowledge of the students. The second was carried out through a discussion forum, with a focus on raising the awareness of health professionals to improve compliance – the evaluation was qualitative. In the third a reapplication of the multiple-choice test was performed with automatic feedback by the system. The fourth was practical – the participants analyzed two videos published on the platform. This analysis should be performed in accordance with the eleven steps of the hand hygiene technique recommended by the Brazilian Ministry of Health, identifying the shortcomings in the videos. In the fifth the students had to prepare their own hand sanitation video following the proposed technique – the evaluation included individual feedback. The sixth evaluation was performed on site and carried a Structured Objective Clinical Examination in a simulated situation, in which the student should report the appropriate moments for hand hygiene. Afterwards the students demonstrated the hand hygiene technique and received instantenous individual feedback. Results: among the 99 students enrolled, eight students did not attend (8.1%), 84 students (92.3%; N=91) passed, and seven (7.7%; N=91) failed for not completing all required activities. The first activity presented the average score of 8.00 among all participants. In the second activity, healthcare education and ratings of infection control were the factors with the greatest impact on awareness. Implementing the trainings was the most frequent proposal of the participants to improve awareness. The third, fourth, fifth and sixth activities respectively had average scores of 8.50, 6.50, 9.80 and 9.60 among the students. Conclusion: the participants presented a good performance in the evaluation of previous knowledge, which suggests an adequate theoretical learning in the medicine graduation course. The discussions and reflections were coherent, with feasible proposals, for implementation to improve compliance. The evaluation of handwashing ability initially presented a poor performance, despite the theoretical knowledge being satisfactory. There was a gap between "knowing" and "demonstrating how it is done", revealing the need to implement activities that contemplate the skill of hand hygiene in the curriculum. Several evaluation methods were used, the predominant being the formative evaluation associated with feedback, which contributed to a meaningful learning throughout the training, in which the student demonstrated "how to be done". The modality of DLPs as a fundamental tool in curricular and extracurricular activities should be considered for hand hygiene training as well as its implementation in hospital infection control / Introdução: a higienização das mãos do profissional de saúde é a medida de maior impacto na eficácia da prevenção e controle de infecções relacionadas à assistência à saúde. Medida básica e de simples execução, vem sendo um desafio mundial pela sua baixa adesão, apesar de várias estratégias utilizadas pela Organização Mundial da Saúde. Objetivos: avaliar a aprendizagem na capacitação em higiene das mãos, em acadêmicos do curso de Medicina, por meio de EaD. Os objetivos específicos foram de capacitar estudantes de Medicina em higienização das mãos; avaliar uma capacitação de higiene de mãos em EaD e colaborar com o programa de controle de infecção hospitalar com uma capacitação de higiene de mãos por meio da EaD. Material e método: foram incluídos 99 acadêmicos do curso de Medicina UNIFEV, com uma abordagem qualitativa e quantitativa, de forma exploratória. A capacitação foi composta por seis atividades, cinco online, sendo a sexta presencial. A primeira foi a aplicação de questões de múltipla escolha, com avaliação somativa, para a análise dos conhecimentos prévios dos acadêmicos. A segunda foi realizada por meio de um Fórum de discussão, com abordagem na sensibilização dos profissionais de saúde para melhorar a sua apreensão, a avaliação foi qualitativa. Na terceira, foi realizada a reaplicação das questões de múltipla escolha com feedback automático pelo sistema. A quarta foi prática; os participantes fizeram uma análise de dois vídeos publicados na plataforma. Esta análise deveria ser de acordo com os onze passos da técnica de higiene das mãos preconizados pelo Ministério da Saúde, referenciando-se as inadequações apresentadas por estes, na plataforma. Na quinta foi proposto para que os acadêmicos elaborassem um vídeo de higienização das mãos, seguindo a técnica proposta, a avaliação incluiu feedback individual. A sexta avaliação foi presencial com realização de um Exame Clínico Objetivo Estruturado (OSCE), com simulação de situação real, na qual o acadêmico deveria relatar os momentos oportunos para higienização das mãos. Posteriormente, os estudantes demonstraram a técnica da higiene das mãos, com realização de feedback individual e oportuno. Resultados: dentre os 99 acadêmicos inscritos, houve desistência de oito acadêmicos (8,1%), aprovação de 84 acadêmicos (92,3%; N=91) e sete reprovas (7,7%; N=9) por não realizarem as atividades propostas. A primeira atividade apresentou como resultado a nota média de 8,00 entre os participantes. Na segunda, os indicadores de controle de infecções e a educação em saúde foram os fatores de maior impacto na sensibilização. Implementar as capacitações foi a proposta mais frequente dos participantes para melhorar a sensibilização. A terceira, quarta, quinta e sexta atividades obtiveram respectivamente notas médias de 8,5; 6,5; 9,80 e 9,60 entre os acadêmicos. Conclusão: os acadêmicos apresentaram um bom desempenho na avaliação de conhecimento prévio, que sugeriu uma abordagem teórica adequada na graduação do curso de Medicina. As discussões e reflexões foram coerentes, com propostas factíveis, nas ações para melhoria da adesão. A avaliação da habilidade da lavagem das mãos apresentou inicialmente um baixo desempenho, apesar do conhecimento teórico ter-se apresentado satisfatório. Notou-se uma lacuna entre o “saber” e o “demonstrar como se faz”, revelando a necessidade de implementação de atividades que contemplem a habilidade de higienização das mãos na grade curricular. Diversos métodos para avaliação foram utilizados, a predominante foi a avaliação formativa associada ao feedback, que colaborou para uma aprendizagem significativa ao longo da capacitação, em que os acadêmicos demonstraram neste momento o “fazer”. A modalidade de EaD, enquanto ferramenta fundamental nas atividades curriculares e extracurriculares, deve ser considerada para capacitações de higiene das mãos, e sua implementação em programas de controle de infecção hospitalar

Thesis (MPH.) -- University of Limpopo, 2016 / Background: The purpose of the study was to find out if hand hygiene was being done according to World Health Organization hand hygiene Guideline. It was hoped that the study would benefit all health care workers through making recommendations aimed at improving hand hygiene compliance. Purpose: The aim of the study was to assess hand hygiene practices among healthcare workers in Nyangabgwe Hospital, Francistown, Botswana Methods: Quantitative, Cross-sectional study, using a self-administered Questionnaire to collect data on 280 participants. The questionnaire consisted of three (3) sections: socio-demographic profile; attitudes of HCWs and practice of healthcare on hand hygiene. For attitude questions Three (3) point Likert scale was used. The sampled Healthcare workers were stratified. The results were analysed using SPSS version 24.0. The descriptive statistical method was used to analyse frequencies, correlations and means. The chi-squared was used to analyse cross tabulation between variables and association with significance level at (p < = 0.05). Results: The results shows that 260 participants aged between 20- 60years responded to the questionnaire. The majority of participants had good knowledge of hand hygiene and younger participants practiced hand hygiene more than older ones (p<.05). Barriers to hand hygiene were significant and included lack of time, negative attitude, but not lack of knowledge. Conclusion: The study highlighted the practices of hand hygiene among health care workers and the status of hand hygiene resources in the hospital which have a negative impact on hand hygiene practices demonstrated that compliance with hand hygiene compliance among health care workers remains unacceptably low, despite xiv the irrefutable scientific evidence that hands are the most common vehicle for transmission of pathogens Keywords: Hand hygiene, Health care workers, Hand hygiene practices, Health care associated infection, Resources.