Assessment of nurses’ perceptions and adherence to five moments of hand hygiene in selected units at a university teaching hospital in Rwanda.

Abstract

Background to the study: About 1.4 million people worldwide are affected by health care associated infections (HCAIs) especially in developing countries. It is proven that about 50% of HCAIs occurs due to hand of healthcare providers. The WHO introduced in 2009 the new concept of “My five moments of hand hygiene to deal with this burden of HCAIs. Though the reduction of HCAIs through hand hygiene was incorporated among the Rwanda Hospital Accreditation Standards, these infections are still prevalent (15.1%) at University Teaching Hospital Kigali (UTHK) and the researcher didn‟t find any study conducted about hand hygiene adherence among nurses in this hospital. The aim of the study: To assess nurses‟ perceptions and adherence to the WHO five moments of hand hygiene at UTHK. Methods: A quantitative descriptive cross -sectional study design was used. The sample size consisted of 84 nurses selected using convenient sampling among 106 nurses working at UTHK in Surgical and ICU. Both questionnaire and direct observation were used to collect the data. The questionnaire was pre-tested and the observers were trained and validated. SPSS version 21and Excel were used to analyze data quantitatively. Results: The study findings revealed positive perceptions of participants about hand hygiene and HCAIs, the overall adherence rate to WHO five moments was 53.6% with the high adherence rate after body fluid exposure risk ( 82.1%) and the lowest before touching a patient (27.4%). Discussion: The observed low overall adherence rate in this study is in the range of compliance rates (5% to 81% , average below 40%) estimated by WHO (CDC, 2010 & Nteli et al., (2014)). The observed very low adherence rate before touching a patient is common elsewhere as evidenced in various studies by Mearkle et al., (2016) and Santos & Celina (2015) Recommendations and conclusion: The concept of WHO five moments of hand hygiene should be integrated in Nursing curriculum, UTHK should reinforce the implementation of hand hygiene promoting strategies as recommended by WHO. Further research in hand hygiene should be conducted. The observed adherence rate to the WHO five moments was inadequate to ascertain the reduction of healthcare-associated infections at an optimum level. Therefore, strategies to raise hand hygiene adherence rate should consider also the rapid increase of HCAIs.