SUMMARY Background: The practice of hand hygiene by nurses is important in preventing and decreasing hospital-associated infections. There are guidelines from WHO available about correct hand hygiene and it is not clear if nurses in low-income countries follow these guidelines. Aim: The aim of this review was to describe the challenges related to hand hygiene these nurses experience. Method: A qualitative literature review was conducted using twelve articles that were analysed using Friberg’s five-step analysis. The search was done in databases CINAHL, MEDLINE and PubMed. Results: The results were categorised into three categories; Challenges in education, Challenges in the working environment and Challenges in compliance. Most nurses in low-income countries were well-informed about hand hygiene, but many had undermined the practice due to lack of regular training, lack of necessary resources, feedback and role models. Conclusion: The study revealed that these nurses had knowledge about hand hygiene, although some of them showed confusion in hand hygiene products and routine. The review identified hindrances to effective hand hygiene practices in low-income countries. Regular courses about effective hand hygiene for nurses are recommended. Further research on qualitative data on hand hygiene while focusing on nurses’ experience in low-income countries is needed. / SAMMANFATTNING Bakgrund: Sjuksköterskan handhygien är viktigt för förbyggande och minskning av vårdrelaterade infektioner. Det finns riktlinjer från WHO om korrekt handhygien men det är inte tydligt om sjuksköterskor i låginkomstländer följer dessa riktlinjer. Syfte: Syftet var att beskriva de utmaningar som sjuksköterskor i låginkomstländer upplever relaterat till handhygien. Metod: En kvalitativ litteraturöversikt genomfördes där tolv artiklar analyserades med Fribergs femstegsanalys. Sökningen av artiklar utfördes i databaserna; CINAHL, MEDLINE och PubMed.  Resultat: Resultatet delades in i tre kategorier; Utmaningar i utbildning, Utmaningar i arbetsmiljö och Utmaningar i följsamhet. De flesta sjuksköterskor i låginkomstländer var välinformerade om handhygien, men många undervärderade god handhygien på grund av oregelbunden utbildning, brist på nödvändiga resurser, feedback och förebilder. Slutsats: Studien visade att sjuksköterskorna ofta hade kunskap om handhygien, men att en del sjuksköterskor var konfunderade angående produkter för handhygien och rutiner. Regelbundna kurser om effektiv handhygien för sjuksköterskor rekommenderas och vidare forskning av kvalitativ data om handhygien med fokus på sjuksköterskors erfarenheter i låginkomstländer efterfrågas.

Bakgrund: Vårdrelaterade infektioner är ett problem som tar upp resurser och vårdplatser. Ett av huvudproblemen är brister i handhygienen. Handhygienen ska utföras korrekt för att bedriva en god och säker vård. Det sistnämnda är en kärnkompetens hos den utbildade sjuksköterskor. Händerna utgör en smittväg mellan vårdpersonal och patienter. För att förhindra detta används skyddsutrustning men även handtvätt och handdesinfektion. Trots kunskap om handhygienens betydelse ses bristande tillämpning bland vårdpersonal.Syfte: Syftet är att identifiera faktorer som kan associeras med följsamheten till handhygien hos vårdpersonal inom somatisk slutenvård.Metod: I detta arbete har en litteraturstudie gjorts. Metoden som valts för att svara på syftet  är en kvantitativ metod. Observationsstudier (7) samt kombinerad observation och enkätstudier (3). Databaserna som användes var PubMed och Cinahl för att få fram relevanta artiklar.Resultat: Tio artiklar har sammanställts för att besvara syftet. Resultatet visade att handtvätt görs för sällan och ersätts med desinfektionsmedel. Arbetsbelastning och utbrändhet leder till sämre följsamhet till handhygien. Att handhygien spelar roll beroende av vilket typ av moment som ska genomföras. Följsamheten till handhygien var sämre innan kontakt med patientkontakt än efter. Slutsats: Dålig handhygien har setts på grund av olika faktorer, detta minskar patientsäkerheten genom risken för eventuell vårdrelaterade infektioner (VRI). Genom god handhygien minskar risken för smittbara ämnen vilket främjar både samhället och patienten. / Background: Healthcare related infections are a big problem in our society. This takes up unnecessary resources and hospital beds. One of the main problems is deficiencies in hand hygiene. Hand hygiene has to be performed correctly to provide good and safe care. Safe care is one of the nurses core competencies. Our hands transmit bacteria and viruses infections between the patient and healthcare professionals. To prevent this use protective equipment but also hand washing and hand disinfection. Aim: the purpose is to identify factors that can be associated with compliance with hand hygiene among care staff in somatic inpatient care.Method: In this work a literature study has been used. Observation studies (7) but also combined observation and questionnaire studies (3) was applied. Cinahl and PubMed were used as databases.Result: A total of ten articles were included in the result. The result showed that handwashing is not done as often as it should, and getting replaced with hand disinfection, workload and burnout leads to less compliance with hand hygiene. Hand hygiene plays a role depending on the type of procedures that are going to be performed. Adherens to hand hygiene were worse before patient contact than after. Conclusion: Poor hand hygiene has been due to various factors. This reduces patient safety through the risk of possible healthcare related infections (HRI). Good hand hygiene reduces the risk of infectious substances, which promotes both society and the patient.

<p>Most foodborne illnesses result from inappropriate food handling practices. One proven practice to reduce pathogens is to perform effective hand-hygiene before all stages of food handling. In food handling, there exist steps to achieve good manufacturing practices (GMPs). Traditionally, the assessment of food handling quality would require hiring a food expert for audit, which is expensive in cost. Recently, recognizing activities in videos becomes a rapidly growing field with wide-ranging applications. In this presentation, we propose to approach the assessment of hand-hygiene quality, which is a crucial step in food handling, with video analytic methods: action recognition and action detection algorithms. Our approaches focus on hand-hygiene activities with different requirements include camera views and scenario variations. </p> <p> </p> For hand-hygiene with egocentric video data, we create a two-stage system to localize and recognize all the hand-hygiene actions in each untrimmed video. This involves applying a low-cost hand mask and motion histogram features to localize the temporal regions of hand-hygiene actions. For hand-hygiene with multi-camera view video data, we design a system processes untrimmed video from both egocentric and third-person cameras, and each hand-hygiene action is recognized with its “expert” camera view. For hand-hygiene across different scenarios, we propose a multi-modality framework to recognize hand-hygiene actions in untrimmed video sequences. We use modalities such as RGB, optical flow, hand segmentation mask, and human skeleton joint modalities to construct individual CNN and apply a hierarchical method to recognize hand-hygiene action

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.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21258号 / 医博第4376号 / 新制||医||1029(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 松村 由美, 教授 伊達 洋至, 教授 中川 一路 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Den vanligast förekommande smittspridningen sker via händer. Trots stor kunskap om vikten av handhygien bland sjukvårdspersonal har olika studier visat att följsamheten inte motsvarar det förväntade.Syftet med den här litteraturstudien är att belysa läkares och sjuksköterskors kunskap om, attityder och följsamhet till handhygien samt att belysa eventuella skillnader. Arbetet omfattar tio vetenskapliga artiklar från Europa och Nordamerika samt litteratur för att besvara uppsatsens frågeställning. Resultatet i den här uppsatsen visar att både läkare och sjuksköterskor har relativt goda kunskaper om handhygien men där läkare och sjuksköterskor jämförs har sjuksköterskor bättre kunskaper. De vanligaste orsakerna till negativa attityder är tidsbrist samt torr och irriterad hud p g a handtvättningsmaterial. Kunskap och attityder är två bidragande faktorer till god eller dålig följsamhet till handhygien. / The most common way for transmission of infections occurs via hands. Despite great knowledge of the importance of hand hygiene among health care workers several studies have shown that compliance doesn’t fulfil the expected. The aim of this study is to illustrate physicians’ and nurses’ knowledge, attitudes and compliance to hand hygiene and to evaluate probable differences. The result of the study is based on ten scientific articles from Europe and North America to answer the study’s questions at issue. The result of this study shows that both physicians and nurses have relatively good knowledge of hand hygiene but when doctors and nurses are compared, nurses have better knowledge. The most common reasons to negative attitudes are lack of time and dry and irritated skin due to hand hygiene material. Knowledge and attitudes are two contributing factors to good or poor compliance to hand hygiene.

Bakgrund Basala hygienrutiner inklusive handhygien är den mest fundamentala åtgärd för att förhindra smittspridning. WHO har tagit fram riktlinjer för sjukvårdspersonal när och hur handhygien ska utföras. Indirekt kontaktsmitta är den vanligaste smittvägen förmikroorganismer inom sjukhus där främsta mellanled är sjukvårdspersonalens händer. Tidigare forskning har visat att sjuksköterskor brister i följsamhet till handhygien. Vårdrelaterade infektioner och multiresistenta mikroorganismer kan leda till lidande förindividen. I sjuksköterskans ansvarsområde ingår att lindra lidande och främja hälsa. Syfte Syftet var att beskriva vad som påverkar sjuksköterskors följsamhet vad gäller handhygien inom sjukhus. Metod Studien genomfördes med designen icke-systematisk litteraturöversikt. Genom sökningar med specifika söktermer i databaserna CINAHL complete och PubMed identifierades 15 vetenskapliga artiklar som kvalitetsgranskades utifrån Sophiahemmet Högskolakvalitetsgranskningsmall. Genom integrerad dataanalys sammanställdes resultatet i identifierade kategorier. Resultat De fyra identifierade huvudkategorierna i resultatet var Individuella barriärer och motivationer, Barriärer och motivationer på avdelningen, Tillgänglighet av handhygienmaterial och När och vart sjuksköterskan arbetar samt försvårande tillfällen. Dessa huvudkategorier bestod av åtta subkategorier. Identifierade faktorer som påverkadesjuksköterskors följsamhet till handhygien var bland annat arbetsbelastning, stöd frånchefer, motivation att skydda patienten samt hudirritation, torrhet och skador på händerna. Slutsats Resultatet visade på både organisatoriska och individuella faktorer som påverkadesjuksköterskors följsamhet till handhygien. Litteraturöversiktens syfte besvarades genom fyra övergripande huvudkategorier i resultatet vilka alla påverkade sjuksköterskors följsamhet till handhygien. I somliga kategorier framkom barriärer vilket hade negativinverkan på följsamhet, och i andra kategorier motivationer som påverkade följsamheten positivt. Handhygien är grundläggande för sjuksköterskor och resultatet kan bidra tillförbättringsarbete på organisatorisk och individuell nivå. / Background Basic hygiene routines, including hand hygiene, is the most fundamental measure in transmission prevention. The WHO has developed guidelines for when and how healthcare workers should perform hand hygiene. The most common pathway of transmission in hospitals is indirect contact transmission, where healthcare professionals' hands are the foremost intermediaries. Previous research show nurses lack of compliance for handhygiene. Healthcare associated infections and multiresistant microorganisms can lead to suffering for the individual. Ease of suffering and promoting health is the nurse’s responsibility. Aim The aim was to describe what affects nurse's adherence to hand hygiene in hospital settings. Method The method for this study was non-systematic literature review. Through searches with specific keywords in the databases CINAHL complete and PubMed, 15 scientific articles were identified through inclusion- and exclusion criterions. The quality of identified articles was assessed with Sophiahemmet Högskolas quality review template. The result was compiled in identified categories through integrative data analysis. Results The results of this literature review were presented with four main categories: Individual barriers and motivations, Barriers and motivations on the ward, Availability of handhygiene materials lastly When and where the nurse works and aggravating situations. These main categories were based on eight subcategories. The identified factors that affected nurse’s compliance to hand hygiene included workload, support from manager, motivation to protect patients, skin irritation, dryness and sore hands. Conclusions The result showed that both organizational and individual factors affected nurses handhygiene compliance. The purpose of this literature review was answered through four categorizes, all affected nurses hand hygiene compliance. In some categories, barriers that effected the compliance negatively were found. In other categories motivations with positive impact were identified. Hand hygiene is fundamental for nurses and the result can contribute to improvement work on both an organisational and individual level.

Background: Hand hygiene is now, more than ever, one of the most important factors to minimize spread of infection. In low income countries like Lesotho between 6% - 19% of patients contract at least one healthcare associated infection. Compared to between 3% - 10% in high income countries. Objective: The aim was to describe how healthcare professionals experience and conduct basic hand hygiene procedures at a hospital in Lesotho. Method: The study was conducted using a qualitative content analysis with a manifest level of abstraction and an inductive approach. Result: The results showed in our final categories; Healthcare professionals perceive different views on the risk for contamination, Healthcare professionals described hand hygiene as important although there are hindrances, and Healthcare professionals stated that basic hand hygiene need support from management for good compliance. That healthcare professionals did not always perform basic hand hygiene the way it was supposed as low budget or lack of knowledge was an obstacle. Conclusions: There are many problem areas, such as cost, availability and knowledge although the personnel are interested, resourceful and willing to make the best of any situation they come across.

The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO’s Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman’s test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. There also were no statistical differences in perception of hand hygiene in the CNA sample. Infection frequency was reduced with a percent change of -42%. While results of knowledge and perception surveys were not statistically significant, multiple conclusions were derived to suggest that educational opportunities may impact hand hygiene practice in CNAs and lead to a decrease in infection.

An increase in outbreaks caused by zoonotic agents has brought about intensified efforts to address the transmission of infectious organisms in animal settings. In October 2002, the CDC released recommendations for the use of waterless hand sanitizer (WHS) in human healthcare settings. The question arises whether WHS may be as effective in veterinary and animal agricultural settings given some of the dissimilarities in conditions. To address this question, three studies were conducted. The first was a retrospective analysis of a Samonella agona outbreak which occurred in 2001 at the Large Animal Teaching Hospital of the Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM). The second evaluated the pattern of use and efficacy of hand hygiene products in the VMRCVM Large Animal Hospital. The third study assessed the efficacy of WHS among visitors to a children's petting zoo at the 2002 Virginia State Fair. Regarding the Salmonella outbreak, it is thought that a calf from the university owned dairy herd was the index case. A total of 16 equine patients acquired S. agona while hospitalized. The nosocomial disease incidence risk for in-house patients was estimated to be 33% (16/49). The LAH was closed for 7 months for cleaning, disinfection and renovation. The total cost of the outbreak was estimated to be at least $755,000. Waterless hand sanitizer proved useful in the veterinary hospital setting. When measured immediately after use, WHS reduced bacterial loads on the hands of 20 LAH personnel (P < 0.001). Before WHS use, HBC ranged from less than to 20 to 48,800 CFU/ml with a geometric mean of 6,926 CFU/ml. Counts after WHS use ranged from less than 20 to 23,400 with a geometric mean of 1,152 CFU/ml. Differences in before and after ranged from -4,000 to 48,200 CFU/ml with a median of 9,700 CFU/ml. The logarithmic reduction in bacterial load before and after WHS use was 0.78 (79.7%). In the petting zoo study, bacterial counts on the fingers of the children sampled before use of WHS ranged from 40 to 75,200 CFU/ml with a geometric mean of 8,653 CFU/ml. After WHS use, bacterial growth ranged from 19 to 58,400 CFU/ml with a geometric mean of 1,727 CFU/ml. Differences in before and after ranged from -35,600 to 59,400 CFU/ml with a median of 8,190 CFU/ml. The logarithmic reduction in bacterial load before and after WHS use was 0.70 (82.2%; P< 0.001). These data suggest that WHS may be of benefit in veterinary medicine and animal agriculture as a means to reduce nosocomial and zoonotic infections. / Master of Science