A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital

Miguela A. Caniza, Lourdes Dueñas, Blanca Lopez, Alicia Rodriguez, Gabriela Maron, Randall Hayden, Deo Kumar Srivastava, Jonathan Mccullers

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Resource-poor hospitals have many barriers to proper hand hygiene (HH). Alcohol-based HH can compensate for inadequate infrastructure and supplies. We describe the implementation of alcohol-based HH in five high-risk wards of a pediatric hospital in El Salvador. Methods: In 5 high-risk wards for nosocomial infections, we evaluated the accessibility, supplies, and cleanliness of the hand-washing sinks at 132 time points. We then installed gel dispensers, identified a local gel supplier, and trained nursing staff to maintain the dispensers. We evaluated user acceptance, costs, and the practice and technique of HH before and after installation. Results: Access and cleanliness were adequate at 18.9% and 11.3% of observation points, and towels and soap were available at 61.3% and 93.18% of points. Placement of 35 gel dispensers increased the ratio of HH stations to beds from 1:6.2 to 1:1.8. Alcohol gel was better tolerated than hand washing among 60 surveyed staff. Installation cost $2558 (US) and the monthly gel supply, $731 (US). HH practice increased from 33.8% to 40.5%; use of correct technique increased from 73.8% to 95.2%. Conclusion: Alcohol gel can address some of the barriers to effective HH at resource-poor institutions, and its cost may be offset by reduction of nosocomial infection.

Original languageEnglish (US)
Pages (from-to)851-854
Number of pages4
JournalAmerican Journal of Infection Control
Volume37
Issue number10
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

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Hand Hygiene
Pediatric Hospitals
Alcohols
Gels
Hand Disinfection
Cross Infection
Costs and Cost Analysis
El Salvador
Soaps
Nursing Staff
Observation

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital. / Caniza, Miguela A.; Dueñas, Lourdes; Lopez, Blanca; Rodriguez, Alicia; Maron, Gabriela; Hayden, Randall; Srivastava, Deo Kumar; Mccullers, Jonathan.

In: American Journal of Infection Control, Vol. 37, No. 10, 01.12.2009, p. 851-854.

Research output: Contribution to journalArticle

Caniza, Miguela A. ; Dueñas, Lourdes ; Lopez, Blanca ; Rodriguez, Alicia ; Maron, Gabriela ; Hayden, Randall ; Srivastava, Deo Kumar ; Mccullers, Jonathan. / A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital. In: American Journal of Infection Control. 2009 ; Vol. 37, No. 10. pp. 851-854.
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abstract = "Background: Resource-poor hospitals have many barriers to proper hand hygiene (HH). Alcohol-based HH can compensate for inadequate infrastructure and supplies. We describe the implementation of alcohol-based HH in five high-risk wards of a pediatric hospital in El Salvador. Methods: In 5 high-risk wards for nosocomial infections, we evaluated the accessibility, supplies, and cleanliness of the hand-washing sinks at 132 time points. We then installed gel dispensers, identified a local gel supplier, and trained nursing staff to maintain the dispensers. We evaluated user acceptance, costs, and the practice and technique of HH before and after installation. Results: Access and cleanliness were adequate at 18.9{\%} and 11.3{\%} of observation points, and towels and soap were available at 61.3{\%} and 93.18{\%} of points. Placement of 35 gel dispensers increased the ratio of HH stations to beds from 1:6.2 to 1:1.8. Alcohol gel was better tolerated than hand washing among 60 surveyed staff. Installation cost $2558 (US) and the monthly gel supply, $731 (US). HH practice increased from 33.8{\%} to 40.5{\%}; use of correct technique increased from 73.8{\%} to 95.2{\%}. Conclusion: Alcohol gel can address some of the barriers to effective HH at resource-poor institutions, and its cost may be offset by reduction of nosocomial infection.",
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