5 Hand Hygiene Moments

The 5 hand hygiene moments is one of the new strategies developed by World Health Organisation (WHO) as a way of adding value to hand hygiene improvement strategies available in healthcare facilities and contexts (World Health Organization, 2010). The moments outlined by the strategy include; before touching a patient, before clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. These moments are self-explanatory sine the developers put them in a simple language that can be understood easily. However, the applicability of these guidelines poses a technical challenge. It is a clear guideline that is well-aligned with evidence base on the spread on healthcare-associated infections. Thus, focusing on hand hygiene has a great impact especially in improving safety of patients and other people within a healthcare facility.

World Health Organisation has selected hand hygiene as the first pillar in implementing and promoting the Global Patient Safety Challenge. This is a clear indicator that hand hygiene is an important measure in achieving patient safety agenda. World Health Organisation (2018) noes that HAI infections are less prevalent due to adoption of hand hygiene strategies. This is facilitated by the availability of the advanced technologies and treatments. Thus, it would be prudent for healthcare facilities to include the strategy in their daily undertakings. It is clear that hand hygiene supports quarantine measures to prevent the spread of dangerous diseases such as Ebola. Mechanisms for Measuring Compliance and Reporting Several mechanism can be put in place to measure and report compliance with hand hygiene strategies.

Consumption of hand hygiene products, installation of electronic systems, and unobtrusive direct observation are some of the key mechanisms that guarantee measurement and reporting on compliance with hand hygiene programs within healthcare facilities (Randle, Firth, & Vaughan, 2013). The use of hand hygiene products especially the alcohol-based hand-rub, is a very important indicator of compliance with hand hygiene. Observers can also be trained and validated by using the WHO Hand Hygiene Training Films and Slides. The WHO observation form exists for both hospitals and outpatient care settings. The use of unobtrusive direct observation has a number of advantages. The observer can gather real time information on what the target population does rather whatever they would say in an interview or write in a questionnaire.

This is very important in avoiding falsification of data. Some well-known observational pieces of research took some years of observation and immersion in a situation or culture (De Wandel, Maes, Labeau, Vereecken, & Blot, 2010). However, it is more common in modern research to reduce the observation time substantially. Observation time may be further reduced in experimental conditions (laboratory or simulation) in other words, controlled settings. An important potential disadvantage, in conducting observational research, is the ethical dilemmas inherent in observing real life situations for research purposes. Some situations may be too revealing beyond the expected limits and cannot be published thus the observer may end having challenges while choosing what to include or delete from final results.   Part II: Healthcare Worker Compliance with 5 Hand Hygiene Moments Healthcare Worker Compliance Mahfouz, El Gamal, & Al-Azraqi (2013) concluded that compliance rates of 41% respectively among ICU workers in different Saudi Hospitals.

They documented frequent risk factors for non-compliance as being a physician or allied health professional, working in the morning shift. Also, the results differed in certain work units such as the intensive care unit. Randle, Firth, & Vaughan (2013), reported variable hand hygiene compliance rates among different health workers observed i. e. Non-availability of infection prevention equipment is a major reason for non-compliance with universal infection prevention precautions in Nigeria (Amoran and Onwube, 2013). Yawson et al (2013) indicated that deficient facilities for hand hygiene especially alcohol-based hand-rubs and liquid soap dispensers were responsible for poor compliance rates among healthcare workers. Religious faith and culture can strongly influence hand hygiene behaviour in HCWs and potentially affect compliance with best practices. To better understand Muslim HCW attitudes toward alcohol-based hand cleansers in an Islamic country, the study by Chou, Kerridge, Kulkarni, Wickman, & Malow (2010), conducted in the Kingdom of Saudi Arabia, is very instructive.

Despite the fact that Saudi Arabia is considered the historic epicentre of Islam, no state policy or permission or fatwa (Islamic religious edict) was sought for the approval of alcohol-based hand-rubs. (2014) highlighted some of the devices which detect changes in hand hygiene practices over time which give feedback to the healthcare providers and facility managers for corrective action. Part III: Discussion and Conclusion Clearly, compliance with the 5 hand hygiene moments can be raised significantly among healthcare workers. As noted above, whenever there are favourable conditions, healthcare workers will tend to improve their compliance with the 5 hand hygiene moments. All the factors that influence better compliance among healthcare workers can be improved through various actions thus; it is possible to achieve high percentages in compliance.

Education, motivation, audits, Religious faith and culture, availability of hand hygiene products, and reminders could serve to improve compliance among healthcare workers if all of these factors are upheld. , Eredie, A.  E. , Landers, T.  F. , Malefia, Y. doi:10. 4103/0974-777x. 122010 Boyce, J. M. , Cooper, T. , Kerridge, J. , Kulkarni, M. , Wickman, K. , & Malow, J. Changing the culture of hand hygiene compliance using a bundle that includes a violation letter. 007 De Wandel, D. , Maes, L. , Labeau, S. , Vereecken, C. , & Blot, S. doi:10. 1136/bmjqs-2011-000056 Mahfouz, A.  A. , El Gamal, M.  N.  Clinical Microbiology and Infection, 20(1), 29-33. doi:10. 12458 Randle, J. , Firth, J. , & Vaughan, N. , … Hardie, K. Impact of an educational intervention upon the hand hygiene compliance of children.  Journal of Hospital Infection, 85(3), 220-225. doi:10.