IJCRR - 5(24), December, 2013
EFFECT OF HAND WASHING AMONG NURSING STAFFS IN TERTIARY CARE HOSPITAL : A STUDY
Author: Suvarna Sande, Silpi Basak, Vidya Tawade
Background and objective: Health care Associated Infection (HAI) is a major problem worldwide. Contaminated hands of health care workers (HCWs) play an important role in the transmission of pathogens. Hand washing is considered to be the most effective method for preventing the transmission of micro-organisms between HCWs and patients. Hence the present study was undertaken to detect the microorganisms present on the hands of Nursing staffs before and after hand washing, in a tertiary care hospital. Method: Swabs were collected from 150 nursing staffs working in various wards and Intensive Care Units (ICUs), from hands before and after hand washing with antimicrobial soap. Swabs were inoculated on blood agar and Mac-Conkey’s agar. Microorganisms were identified by standard methods. Detection of HAI pathogens were done according to Clinical Laboratory Standard Institute (CLSI) guidelines. Result: Out of total 150 samples collected before hand washing, growth was observed in107 (71.3%) samples and no growth in 43(28.7%) samples. Apart from skin commensals, Staphylococcus aureus (20.1%), Enterococcus faecalis (4.6%), Klebsiella pneumoniae (6%), E.coli (4%) and Pseudomonas aeruginosa (1.3%) were detected. 05 Methicillin Resistant Staphylococcus aureus (MRSA) strains were also isolated from hand swabs collected before hand washing. No growth was obtained in 128 (85.3%) samples and growth were observed in 22 (14.7%) samples after hand washing , Conclusion: It is important to perform proper procedure of hand washing technique using an adequate quantity of antimicrobial soap to cover all skin surfaces for the recommended length of time.
Keywords: Health care Associated Infection (HAI), Hand hygiene
Suvarna Sande, Silpi Basak, Vidya Tawade. EFFECT OF HAND WASHING AMONG NURSING STAFFS IN TERTIARY CARE HOSPITAL : A STUDY International Journal of Current Research and Review. 5(24), December, 34-40
- All egranzi B Nejad SB, et al Burden of endemic healthcare associated infection in developing countries: systematic review and meta - analysis, Lancet, 2011; Vol 377: pg 228 - 241.
- World Health Organization (2011). Report on the burden of endemic health care associated infections worldwide. WHO Document Production services ISBN 9789241501507, Geneva
- Larson E. Effects of handwashing agent, handwashing frequency, and clinical area on - hand flora. American Journal of Infection Control, 1984, 11:76-82.
- Larson EL et al. Changes in bacterial flora associated with skin damage on hands of health care personnel. American Journal of Infection Control, 1998, 26:513–521.
- Maki D. Control of colonization and transmission of pathogenic bacteria in the hospital. Annals of Internal Medicine, 1978, 89:777-780.
- Pittet D et al. Bacterial contamination of the hands of hospital staff during routine patient care. Archives of Internal Medicine, 1999, 159:821-826.
- Price PB. The bacteriology of normal skin: a new quantitative test applied to a study of the bacterial flora and the disinfectant action of mechanical cleansing. Journal ofInfectious Diseases, 1938, 63:301–318.
- Evans CA et al. Bacterial flora of the normal human skin. Journal of Investigative Dermatology, 1950, 15:305-324.
- Marples RR, Towers AG. A laboratory model for the investigation of contact transfer of micro-organisms. Journal of Hygiene (London), 1979, 82:237-248.
- Patrick DR, Findon G, Miller TE. Residual moisture determines the level of touch- contact-associated bacterial transfer following hand washing. Epidemiology and
Infection, 1997, 119:319–325.
- Collee JG, Miles RS, Watt B. Tests for the identification of bacteria. In: Collee JG, Marmion BP, Fraser AG, Simmons A, editors. Mackie and Mc Cartney Practical Medical Microbiology. 14th ed. Edinburg: Churchill Livingstone; 1996 . p. 131-50.
- Clinical Laboratory Standards Institute. Performance standards for antimicrobial disk susceptibility tests. Approved standarad M2-A7, 11th ed. Wayne PA: USA; 2007.
- Park K. Park’s Text book of Preventive and Social Medicine. 22nd edition. Jabalpur: Banarasidas Bhanot; 2013. Chapter 19, Health information and basic medical statistic : p 782-796.
- WHO guidelines on Hand Hygiene in Health care. Geneva : World Health Organization : 2009.
- Sanderson PJ, Weissler S. Recovery of coliforms from the hands of nurses and patients: activities leading to contamination. Journal of Hospital Infection, 1992, 21:85–93.
- Boyce JM et al. Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infection Control and Hospital Epidemiology, 1997, 18:622–627.
- McBryde ES et al. An investigation of contact transmission of methicillin-resistant Staphylococcus aureus. Journal of Hospital Infection, 2004, 58:104–108.
- Duckro AN et al. Transfer of vancomycin-resistant Enterococci via health care worker hands. Archives of Internal Medicine, 2005, 165:302–307.
- Ray AJ et al. Nosocomial transmission of vancomycinresistant Enterococci from surfaces. JAMA, 2002, 287:1400–1401.
- Riggs MM et al. Asymptomatic carriers are a potential source for transmission of epidemic and nonepidemic Clostridium difficile strains among long-term care facility
residents. Clinical Infectious Diseases, 2007, 45:992–998.
- Bhalla A et al. Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infection Control and Hospital
Epidemiology, 2004, 25:164–167.
- Ayliffe et al. Hand disinfection: a comparison of various agents in laboratory and ward studies. Journal of Hospital Infection, 1988, 11:226–243.
- Daschner FD. How cost-effective is the present use of antiseptics? Journal of Hospital Infection, 1988, 11(Suppl.A):227–235.
- Waters V et al. Molecular epidemiology of gram-negative bacilli from infected neonates and health care workers’hands in neonatal intensive care units. Clinical Infectious
Diseases, 2004, 38:1682–1687
- Lucet JC et al. Hand contamination before and after different hand hygiene techniques: a randomized clinical trial. Journal of Hospital Infection, 2002, 50:276–280.
- Hugonnet S, Harbarth S, Saz H, Duncan RA and Pitet D, Nursing resourus: a major determinant of nosocomial infection? current opin. Infect Dis. 2004: Vol 17 (4), PG 329-333.
- Pittet D, Hugonnet S, Harbarth S et al , effectiveness of a hospital wide programme to improve compliance with hand hygiene Lancet 2000; 356:1307-1312.