No / Aims: To compare an ultra-rapid hand dryer against warm air dryers, with regard to: (A) bacterial transfer after drying and (B) the impact on bacterial numbers of rubbing hands during dryer use. Methods and Results: The Airblade¿ dryer (Dyson Ltd) uses two air `knives¿ to strip water from still hands, whereas conventional dryers use warm air to evaporate moisture whilst hands are rubbed together. These approaches were compared using 14 volunteers; the Airblade¿ and two types of warm air dryer. In study (A), hands were contaminated by handling meat and then washed in a standardized manner. After dryer use, fingers were pressed onto foil and transfer of residual bacteria enumerated. Transfers of 0¿107 CFU per five fingers were observed. For a drying time of 10 s, the Airblade¿ led to significantly less bacterial transfer than the other dryers (P < 0·05; range 0·0003¿0·0015). When the latter were used for 30¿35 s, the trend was for the Airblade to still perform better, but differences were not significant (P > 0·05, range 0·1317¿0·4099). In study (B), drying was performed ± hand rubbing. Contact plates enumerated bacteria transferred from palms, fingers and fingertips before and after drying. When keeping hands still, there was no statistical difference between dryers, and reduction in the numbers released was almost as high as with paper towels. Rubbing when using the warm air dryers inhibited an overall reduction in bacterial numbers on the skin (P < 0·05). Conclusions: Effective hand drying is important for reducing transfer of commensals or remaining contaminants to surfaces. Rubbing hands during warm air drying can counteract the reduction in bacterial numbers accrued during handwashing. Significance and Impact of the Study: The Airblade¿ was superior to the warm air dryers for reducing bacterial transfer. Its short, 10 s drying time should encourage greater compliance with hand drying and thus help reduce the spread of infectious agents via hands. / Dyson Ltd

Bakgrund Bristande handhygien hos hälso-och sjukvårdspersonal bidrar till smittspridning och ökade kostnader för hälso-och sjukvården. Hälso- och sjukvårdspersonalen har en avgörande roll i att minska smittspridningen med hjälp av noggrant genomförd handhygien. Trots att kunskap i ämnet finns så brister handhygienen och patienterna beroende av sjukvård drabbas av vårdskador i samband med vård och behandling. Syfte Syftet är att beskriva faktorer som påverkar vårdpersonalens följsamhet av hygienrutiner på sjukhus. Metod En litteraturöversikt har genomförts med 13 vetenskapliga artiklar som publicerats under tidsperioden 2012–2024 i databaserna CINAHL och PubMed. Resultat I litteraturöversiktens resultats del kunde tre huvudkategorier hittas: verksamhetsfaktorer, arbetsfaktorer och personliga faktorer. Utifrån dessa tre huvudkategorier kunde åtta underkategorier identifieras. Kategorierna präglas av alltifrån personliga faktorer som glömska och preferenser. Till organisationsfaktorer där bland annat resursbrist och bristande rutiner beskrivs. Slutsats Det breda spektrumet av påverkande faktorer kan förebyggas och åtgärdas genom kunskap och strukturimplementering. På så vis skulle följsamheten till hygienrutiner öka och patientsäkerheten främjas. / Background Insufficient hand hygiene in healthcare contributes to the spread of infection and increased costs for the healthcare system. Healthcare professionals have a decisive role in reducing the spread of infection with the help of carefully implemented hand hygiene, even though there is knowledge on the subject, hand hygiene is lacking and patients dependent on medical care suffer from health care related injuries. Aim The aim is to describe factors that influence healthcare staff's adherence to hygiene routines in hospitals. Method A literature review has been carried out with 13 scientific articles published during theperiod 2012–2024 in the databases CINAHL and PubMed. Results In the results section of the literature review, three main categories could be found: institutional factors, work factors and personal factors. Based on these three main categories, eight subcategories could be identified. The categories are characterized by everything from personal factors such as forgetfulness and preferences. To organizational factors where,among other things, lack of resources and inadequate routines are described. Conclusions The broad spectrum of factors can be prevented and solved with knowledge and implementation of structures. With that the adherence to hygiene routines could increase and the patient safety would be promoted.

The purpose of this study was to describe factors associated with noncompliance to hand hygiene standards among nurses in one public hospital in Windhoek, Namibia. A quantitative, descriptive, cross-sectional research design was employed using a stratified sample comprising three categories of nurses (registered, enrolled and auxiliary nurses). Data collection was done using a structured questionnaire. Based on the results, there were more institutional than individual factors associated with noncompliance to hand hygiene. Compliance to hand hygiene was found to be lowest when nurses provide care for patients in non-isolation rooms, when the perceived risk of acquiring infection from patients was low and following brief encounters with patients. Dryness of the skin caused by hand hygiene agents and lack of active participation in hand hygiene promotion at individual level contributed to noncompliance to hand hygiene among nurses. In addition, the results showed that, institutionally there were no rewards/encouragement for hand hygiene, no sanctions for non-compliers and no workshops, seminars and continuing educational courses on hand hygiene. The study produced interesting insights into the vital role that good leadership plays in the implementation of hand hygiene policy guidelines. The key recommendations for this study included development of good leadership, characterized by dedication for hygiene standards to encourage staff to maintain hygiene practice and to ensure that there are adequate resources for the implementation of hand hygiene policy as well as rewards/incentives for compliers and sanctions for noncompliers / Health Studies / M.A. (Nursing Science)

Sammanfattning Bakgrund: De bakterier som överförs till händerna från omgivningen via föremål och sprider sig vidare mellan individer kan skapa en vårdrelaterad infektion, som i sin tur kan ge ett lidande för den enskilda patienten. Syfte: Syftet med studien var att undersöka följsamheten till basala hygienrutiner och klädregler hos personalen vid patientnära arbete under förberedelserna av patienten på operationssalen. Metod: Metoden av studien genomfördes med en öppen observationsstudie med en kvantitativ design baserad på strukturerade observationsprotokoll. Observationerna av följsamheten till basala hygienrutiner genomfördes när personalen utförde olika arbetsmoment i förberedelserna vid patientnära arbete. Arbetsmoment var positionering av patient inför operation, insättning av urinkateter, perifer venkateter, artärnål, epiduralkateter och intubation av patienten. Observationsstudien genomfördes på en kirurgisk och en ortopedisk operationsavdelning på ett universitetssjukhus i Mellansverige. Resultat: Studien omfattade 10 observationstillfällen per operationsavdelning med totalt 175 observationsmätningar på kirurg- och ortopedoperation angående klädregler, resultatet visade att 98% av personalen på ortopedoperation och 100% på kirurgoperation hade en korrekt följsamhet. Vid samtliga arbetsmoment som observerades förekom det brister vid användning av handdesinfektion före och efter patientnära arbete. Det arbetsmoment där rutinerna brister mest var vid intubation av patienten. Slutsats: I studiens resultat framgår det att personalen har en god följsamhet till klädregler, majoriteten använder engångskläder på båda operationsavdelningarna. När det gäller basala hygienrutiner finns fortfarande arbetsmoment där det finns brister. Vidare forskning och fortsatt utvecklingsarbete kring basala hygienrutiner behövs för att öka kunskap och medvetenhet hos personalen vid patientnära arbete. / Abstract  Background: The bacteria that are transmitted to the hands from the environment through objects and is spreading further among individuals can create a health care associated infection, which in turn can cause a hardship for the individual patient. Purpose: The purpose of this study was to investigate the adherence to basic hygiene and dress code of staff in patient-related work during the preparation of the patient in the operating room. Method: The method of study was conducted with an open observational study with a quantitative design based on structured observation protocol. The observations of adherence to basic hygiene was carried out when the staff performed various tasks in preparation for near patient work. Operations were positioning of the patient before surgery, insertion of urinary catheter, peripheral venous, artery needle, epidural catheter and intubation of the patient. Observational study was conducted in a surgical and orthopedic surgery department at a university in central Sweden. Results: The study involved 10 observation occasions a surgical department with a total of 175 observational measurements on surgical and orthoped operation regarding the dress code, the results showed that 98% of the staff at the orthopedic surgery and 100% in the surgical operation had a proper adherence. In all the operations were observed, there were deficiencies in the use of hand disinfectant before and after patient-related work. The operation in which the routines shortcomings were for intubation of the patient. Conclusion: The results of the study, it appears that the staff has a good adherence to the dress code, the majority use disposable clothing on both operations departments. In terms of basic hygiene are still occupations where there are shortages. Further research and further development work on basic hygiene needed to increase knowledge and awareness of-staff for near patient work.

Intresset för ämnet vårdhygien väcktes under den verksamhetsförlagda utbildningen då vi uppmärksammade att vårdpersonalen på avdelningarna ofta slarvade med handhygien och andra basala hygienrutiner. Vårdrelaterade infektioner beräknas drabba en av tio patienter. Många av dessa infektioner skulle kunna förebyggas genom följsamhet till basala hygienrutiner. Syftet med denna studie var att belysa faktorer som påverkar vårdpersonals följsamhet gällande basala hygienrutiner. En litteraturstudie genomfördes där tio artiklar med kvalitativ och kvantitativ ansats analyserades. Resultatet delades upp i två huvudkategorier och nio underkategorier. De två huvudkategorierna som skapades var Organisatoriska faktorer och Individuella faktorer. Under Organisatoriska faktorer framkom Tidsbrist och arbetsbelastning, Kunskap, Arbetsklimat och förebilder samt Tillgänglighet på material. Under de Individuella faktorerna framkom Attityd, Typ av klinisk procedur, Teknik, Hudirritation och Yrkesgrupper. Studien bidrar till ökad förståelse för dessa faktorers inverkan på följsamheten till basala hygienrutiner. Resultatet visade att brist på tid, kunskap och material försämrade följsamheten till handhygien. Vidare visade resultatet att en arbetsledning och kollegor som var goda förebilder påverkade vårdpersonalen positivt gällande följsamheten. Vårdpersonal var medvetna om riskerna med dålig handhygien men förminskade problemet och attityden till handhygien försämrades över tiden. Läkare hade generellt sett lägre följsamhet än övrig vårdpersonal. Vid vardagliga moment ansågs handhygienen inte vara lika viktig och vid moment som medförde en högrisk för smitta var följsamheten låg. / Interest in infection control developed during the work-based training when we realized that nursing staff in the departments were often careless with hand hygiene and other basic hygiene routines. Healthcare associated infections are estimated to affect one of ten patients. Many of these could be prevented by observing basic hygiene. The purpose of this study was to elucidate factors that influence healthcare staff´s observance of basic hygiene. This was done through a literature study of ten articles consisting of qualitative and quantitative data. The results were divided into two main categories and nine subcategories. The two main categories were Organizational factors and Individual factors. The Organizational factors that emerged were Lack of time and workload, Knowledge, Working environment and role models and Availability of materials. The Individual factors were Attitude, Type of clinical procedure, Techniques, Skin irritation and Professions. The study contributes to a greater understanding of these factors in the observance of basic hygiene. The results showed that lack of time, knowledge and lack of material had a negative influence on the observance of hand hygiene. Furthermore, the results showed that supervisors and colleagues who were good role models influenced medical staff in a positive way. Healthcare staff were aware of the risks of poor hand hygiene but ignored the problem to some extent and the approach to hand hygiene deteriorated with time. Doctors generally had lower observance than other health care staff. In everyday encounters hand hygiene was not considered as important and at moments with a high risk of infection there was generally low compliance.

Introdução: A prevenção de infecções relacionadas com a assistência à saúde (IRAS) é universalmente considerada relevante para os sistemas de saúde, pois afetam tanto os pacientes quanto os profissionais da assistência. As mãos dos profissionais constituem o elo importante na cadeia de transmissão de microrganismos entre o paciente colonizado e aquele que não tem tal status. A higienização das mãos (HM) é o meio mais efetivo para minimizar o risco de transmissão e envolve a escolha de um produto eficaz e bem aceito pelo profissional. Atualmente há indicação preferencial para o uso de produto alcoólico para HM para a maioria das situações. Entretanto, na prática, outros produtos germicidas também têm sido indicados. Entre eles, o gluconato de clorexidina (GCX), que é uma biguanida catiônica que tem sua atividade antimicrobiana atribuída à invasão na membrana e posterior ruptura das membranas citoplasmáticas, resultando na precipitação do conteúdo. O GCX tem sido utilizado em situações específicas, porém ainda sem evidências que justifiquem sua indicação prioritária. Objetivo: O objetivo deste estudo é selecionar e analisar as evidências científicas para fundamentar a indicação prioritária do uso de sabonete com GCX para HM na assistência à saúde. O estudo propõe como objetivos específicos identificar as evidências científicas disponíveis referentes a HM realizada com sabão contendo GCX quanto: a associação com a redução das IRAS, a relação do uso contínuo com a seleção de microrganismos resistentes a GCX e a relação com a saúde da pele das mãos dos profissionais. Método: Trata-se de um estudo de revisão sistemática, finalizada em abril de 2017, cujo método seguiu as recomendações do Instituto Joanna Briggs (JBI) e do Systematic Review and Meta-analysis Protocols (PRISMA-P) 2015. A aplicação da estratégia PICO buscou responder os objetivos específicos. Incluiu-se como base de dados para a pesquisa: Medline, Cinahl, Lilacs, Embase, Cochrane Library, Scopus, Web of Science, ProQuest, Google Scholar e Teses como literatura cinzenta, sem restrição de linguagem e publicadas a partir de 1985. A seleção dos artigos contou com dois revisores que utilizaram instrumentos de avaliação do JBI. Análise dos dados: Este estudo gerou três revisões, uma para cada pergunta de pesquisa. A revisão relacionada a transmissão de infecção incluiu 764 artigos, 40 para leitura integral e quatro estudos incluídos na revisão, 75% dos artigos com desenho quase-experimental, nenhum artigo foi excluído pelo instrumento de avaliação JBI. Os quatro artigos não mostraram diferença significativa de taxas de infecção quando relacionados ao uso do GCX. A revisão relacionada com a seleção de microrganismos resistentes a GCX incluiu 533 artigos, 27 foram para leitura integral e 12 artigos foram selecionados, dois dos quais foram excluídos ao serem avaliados pelos critérios JBI. Entre os 10 artigos, 60 % eram estudos descritivos. A análise dos resultados dos 10 estudos científicos mostra que três não relacionam o uso do GCX com a seleção de microrganismos resistentes enquanto sete estudos sugerem que o uso contínuo pode selecionar microrganismos resistentes a este princípio ativo. A revisão relacionada com a aceitação dermatológica captou 611 artigos, 27 para leitura integral e oito artigos foram selecionados, dos quais 75% eram estudos experimentais. O estudo E6 foi excluído por não atender questão eliminatória do instrumento JBI. A análise dos resultados dos sete estudos sugere que o uso do GCX está associado à maior número de eventos de reação de pele. Conclusão: o uso do GCX para HM não mostrou impacto na redução das IRAS. Os dados sugerem que o uso indevido ou prolongado pode selecionar microrganismos resistentes à GCX e a aplicação do produto está relacionada a eventos de pele, o que pode impactar nas taxas de adesão de HM. / Introduction: The prevention of health care-related infections (HCI) is universally considered relevant for health systems, as they affect both patients and healthcare workers (HCW). In the chain of microorganism transmission the hands of HCW are an important link between the colonized patient and the one who does not have such status. Hand hygiene (HH) is the most effective method to reduce the transmission risk of infection and it involves the selection of an effective product that is well accepted by the HCW. Currently, alcohol-based products are the preferred option for HH for most situations. In practice, however, a range of other microbial products have also been recommended. Among them chlorhexidine gluconate (CHG), a cationic biguanide that has its antimicrobial activity attributed to membrane invasion, and subsequent rupture of cytoplasmic membranes, resulting in precipitation of the content. CHG has been used in specific situations, but it still has no evidence to justify its preferred recommendation. Objective: The aim of this study is to recognize and to summarize scientific evidence to support preferred recommendation of the use of CHG-based soap for hand hygiene in healthcare. The study proposes specific objectives as to identify available scientific evidence regarding CHG-containing soap for HH and determine: its association with the reduction of health care-associated infections (HAIs) transmission, the association of the routine use of CHG and selection of CHG resistant strains, and the association of CHG-based hand washing as well the integrity of HCW hand skin. Method: This is a systematic review study accomplished in April 2017, which was based on the protocol of the Institute Joanna Briggs (JBI) and the recommendations from Systematic Review and Meta- analysis Protocols (PRISMA-P) 2015. PICO strategy was applied in order to address some specific objectives. The database for the research consisted of: Medline, Cinahl, Lilacs, Embase, Cochrane Library, Scopus, Web of Science, ProQuest, Scholar Google and Theses as gray literature without language restriction and published since 1985. The studies selection was carried out by two researchers who used assessment tools from the Institute Joanna Briggs. Data analysis: This study originated three distinct reviews aiming to answer three questions derived from the main research question. The first one, regarding infection transmission included 764 articles, 40 to be entirely read and four studies to be included in the review, 75% of articles with quasi-experimental design, no studies were excluded by JBI assessment instrument. Four articles did not show any significant difference in infection rates associated to the use of CHG. The revision regarding the selection of CHG-resistant microorganisms included 533 articles, 27 to be entirely read and 12 were selected, two of which were excluded after being assessed by JBI criteria. Among 10 articles, 60% were of descriptive studies. Analysis of outcomes of 10 scientific studies showed that three of them did not relate the continuous use of CHG with the selection of resistant microorganisms while seven suggest that long-term use may select resistant strains to this active ingredient. The last one, regarding dermatological acceptance included 611 articles, 27 to be entirely read and eight were selected, being 75% of experimental studies. Study E6 was excluded because it did not address the pré-defined elimination question of JBI instrument. The analysis of outcomes of seven studies suggests that the use of CHG is associated with the higher number of skin reaction events. Conclusion: the use of CHG for HH has not shown any impact on the reduction of IRAS. Data suggest that inappropriate or long-term use of it may select CHG-resistant strains and skin events have been more frequently related to its application when compared to other products, which may have an impact on HH adherence rates.

Bakgrund Kunskapen om att vården orsakar skador har ökat men behöver ständigt förbättras. God tillämpning av handhygien ökar förutsättningarna för säker vård. Handhygienen är den viktigaste faktorn för att minska smittspridning. Vårdrelaterade infektioner (VRI) är vanligaste vårdskadan i Sverige och utgör hot mot patientsäkerheten. VRI medför onödigt lidande hos dem som drabbas samt utgör betydande kostnad på 6,5 miljarder kronor varje år för hälso- och sjukvården.  Belastningen på sjukvården ökar också p.g.a. VRI då det medför 750 000 extra vårddagar per år. Syfte Att beskriva sjuksköterskors följsamhet till handhygien för att utföra säker vård inom medicinsk akutvård. Metod Studien är gjord utifrån kvantitativ retrospektiv ansats med deskriptiv statistisk design. Deskriptiva data har hämtats från registret Mätning och analys (MOA) och sammanställts och analyserats i statistikprogrammet SPSS. Observationer av sjuksköterskors följsamhet till handsprit före och efter patientkontakt har sammanställts och analyserats. Sammanställning av antalet VRI har sammanställts och jämförts med följsamheten till handsprit före och efter patientkontakt, under samma tidsperiod. Resultat Resultatet visar att sjuksköterskornas följsamhet till handhygien på de medicinska akutvårdsavdelningarna som granskats är högre än genomsnittet i Sverige samt att högst följsamhet till handhygien är efter patientkontakt. Resultatet visar att andelen patienter med VRI på de granskade medicinska akutvårdsavdelningarna är lägre än genomsnittet i Sverige. Slutsats Utbildning och återkommande hygienkampanjer ökar följsamheten och medvetenheten hos vårdpersonal. Genom ökad kunskap om smittspridning och följsamhet till handhygien skapas förutsättningar för säker vård. / Background The knowledge, that healthcare causes injuries, has increased, but needs to be constantly improved. A good application of hand hygiene increases the conditions for safe care. Hand hygiene is one of the most important factors in reducing the spread of infection. Healthcare related infections are the most common health related injury in Sweden and are a threat to patient safety. It causes unnecessary suffering for those affected and represents a significant cost of 6.5 billion each year for the society and increased pressure on healthcare through 750,000 extra days of care in hospitals. Objective The purpose was to describe the nurse`s adherence to hand hygiene in order to perform safe care in medical emergency care. Method The study is based on a quantitative retrospective approach with a descriptive statistical design. Descriptive data has been retrieved from the Measurement and Analysis (MOA) register and compiled and analysed in the SPSS statistics program. Observations of nursing adherence to hand disinfection before and after patient contact have been compiled and analysed. A compilation of the registered healthcare related infections has been compiled and compared with the nurse`s adherence to hand disinfections before and after patient contact, during the same time period. Results The result shows that the step with the highest degree of compliance with hand hygiene is after patient contact. The nurses' adherence to hand hygiene in the medical emergency services we reviewed is higher than the average in Sweden and the result shows that the proportion of patients with VRI in the examined medical emergency services is lower than the average in Sweden. Summary Training and recurrent hygiene campaigns increase the compliance and awareness of healthcare professionals. Increased knowledge of compliance with hand hygiene and the spread of infection creates conditions for safe care.

Bakgrund: Säker vård är ett ämne som ständigt är aktuellt inom vården. För att skapa förutsättningar för säker vård är de basala hygienrutinerna en viktig del i omvårdnadsarbete. Patienter inom slutenvården i Sverige drabbas av vårdrelaterade infektioner (VRI) som bidrar till ökade kostnader för samhället, lidande för patienten och är ett hot mot säker vård. Undersökningar gjorda av Sveriges kommuner och landsting visar ett starkt samband mellan följsamheten av de basala hygienrutinerna och VRI.   Syfte: Att undersöka vårdpersonalens följsamhet till basala hygienrutiner på en medicinsk akutvårdsavdelning, med fokus på handhygien och dess betydelse för vårdrelaterade infektioner.   Metod: En kvantitativ empirisk långtidsuppföljning (2013-2018) har genomförts. Observationer har utförts på en medicinsk akutvårdsavdelning i södra Sverige. De yrkesgrupper som observerades var undersköterskor, sjuksköterskor och läkare. Samtlig data har hämtats från registret Mätning och analys (MOA). Deskriptiv data har sammanställts och analyserats genom statistikprogrammet SPSS.   Resultat: Vid analys framkom att följsamheten till handhygien skiljer sig mellan de olika yrkesgrupperna, undersköterskorna visar på högst följsamhet. Det moment där yrkesgrupperna visar på högst följsamhet var handsprit efter patientkontakt.   Slutsats: För att en god och säkervård ska kunna utföras bör vårdpersonal få möjlighet till en bredare kunskap om handhygien och smittspridning. Analysen av långtidsuppföljningen har bekräftat vad tidigare studiers resultat har visat kring följsamhet till handhygien.

Bakgrund: Handhygienrutiner är en grundläggande åtgärd i sjuksköterskans dagliga arbete för att förebygga vårdrelaterade infektioner. Över 1500 patienter dör varje år på grund av bristfällig standard på hygienrutiner. Vårdrelaterade infektioner orsakar stort vårdlidande hos patienten som kan förebyggas med god följsamhet till handhygienrutiner. Syfte: Syftet med denna studie var att beskriva orsaker som påverkar sjuksköterskors följsamhet till riktlinjer vid handhygien på sjukhus. Metod: Metoden som användes var en litteraturöversikt av artiklar med både kvalitativ och kvantitativ ansats. Resultat: Ur analysen av datamaterialet framkom tre huvudkategorier; Risk för smittspridning, omgivningens villighet att ge återkoppling, samt brister i organisationen, med åtta underkategorier. Konklusion: Brister på följsamhet till handhygienrutiner ökar risken för vårdrelaterade infektioner. Det finns ett behov av större insikt inom sjuksköterskors följsamhet till handhygienrutiner för att minska vårdlidandet hos patienten. / Background: Following guidelines for hand hygiene is a basic part of the daily routine of nurses to help prevent healthcare associated infections. Over 1500 patients die every year as the result of poor adherence to hand hygiene guidelines. Health care associated infections result in care suffering for the patient which could have been prevented with higher adherence to hand hygiene guidelines. Aim: The aim of the literature review was to identify what causes nurses adherence to hand hygiene guidelines in a hospital setting. Method: The method used was a literature review where both qualitative and quantitative articles were analyzed. Results: Three main categories emerged from the analysis; risk for infectivity, peers willingness to give feedback and organizational shortcomings, with eight subcategories. Conclusion: Poor adherence to hand hygiene guidelines increases the risk of health care associated infections. To prevent care suffering for the patient there is a need for a deeper understanding for nurses’ adherence to hand hygiene guidelines.

No description available.