Reasons for preference to soap and water included the belief that ABHR contributed to drying of hands ( 60 percent ), harshness of ABHR ( 46 percent ), and burning on ABHR application ( 46 percent ).
As Kirk , et al . ( 2016 ) acknowledge , “ As hand hygiene compliance improves , increased use of hand hygiene products will place greater responsibility on industry to create products that support the skin health needs of the healthcare team . Because skin health issues associated with ABHR were cited as among the most common reasons for preferring soap and water , skin tolerance and user acceptance of ABHR products must rely on hand hygiene product manufacturers to create hand hygiene products that are efficacious while still supporting skin integrity . Organizational support for hand hygiene improvement means engaging frontline healthcare workers in the selection process for hand hygiene products . Educating healthcare workers by improving their understanding of hand hygiene skin science will better inform their use of products and support the maintenance of skin integrity .”
Regarding personal carriage of a small container of ABHR by a healthcare provider to facilitate hand hygiene , this was not a common method of performing hand
• Reasons for preference to soap and water included the belief that ABHR contributed to drying of hands ( 60 %), harshness of ABHR ( 46 %), and burning on ABHR application
( 46 %).
hygiene at the POC , with 75 percent of total participants stating that they “ never ” or “ rarely ” have personal carriage supply with them while providing care . In another question more than half of survey respondents stated that personal carriage was not available for use when providing patient care . Personal carriage of ABHR during patient care was more prevalent in the U . S . than in Canada ( 1.86 and 1.63 , respectively ), and only 15 percent of respondents identified personal carriage as the most helpful method for performing POC hand hygiene .
Kirk , et al . ( 2016 ) say there is room for improvement when it comes to more healthcare professionals fully understanding POC hand hygiene and note , “ To close the gap in understanding POC hand hygiene and practice guidelines , such as hand hygiene , moments should be linked to POC concepts . Facility hand hygiene policies should describe the POC concept and include the provision of ABHR in the patient zone using graphics as well as narrative explanations . More education is needed to clearly define what POC is and how it differs from the patient environment . Learning tools , such as diagrams and figures that clearly identify patient and health care zones , will assist in healthcare provider education .” They add , “ POC hand hygiene is an effective method of promoting hand hygiene at the critical moments when a patient is most vulnerable .”
Critical Points of Care and POC Hand Hygiene
Seeing as POC hand hygiene was designed for critical points of care at the bedside , Chang and Reisinger , et al . ( 2021 ) investigated how the type of clinical task affected healthcare personnel ’ s hand hygiene compliance . The researchers categorized consecutive tasks that healthcare workers performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units ( STAR * ICU ) study into care sequences and identified task pairs consisting of two consecutive tasks and the intervening hand hygiene opportunity . Tasks were defined as critical and / or contaminating .
They found that healthcare workers were less likely to perform hand hygiene before critical tasks than before other tasks and more likely to perform hand hygiene after contaminating tasks than after other tasks . Nurses were more likely to perform both critical and contaminating tasks , but nurses ’ hand hygiene compliance was better than physicians ’ and other healthcare workers ’ compliance .
To complete the picture of how hand hygiene practices can help address transmission vulnerabilities during the patient-care process , Chang and Jones , et al . ( 2021 ) examined whether the order in which healthcare workers perform patient-care tasks affects hand hygiene compliance . The study was conducted in 17 adult surgical , medical , and medical-surgical intensive care units among healthcare workers in the STAR * ICU study units referenced earlier .
The researchers found that healthcare workers moved from cleaner to dirtier tasks during 5,303 transitions ( 34.7 percent ) and from dirtier to cleaner tasks during 10,000 transitions ( 65.4 percent ). Interestingly , physicians and other healthcare professionals were more likely than nurses to move from dirtier to cleaner tasks . Glove use was associated with moving from dirtier to cleaner tasks , and hygiene compliance was lower when healthcare workers transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction .
Facilities may want to consider POC hand hygiene because healthcare personnel may not be organizing patient-care tasks in a manner that decreases risk to patients , and that they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse . These practices could increase the risk of transmission or infection , the researchers emphasize .
As the researchers note , “ The WHO ‘ My 5 Moments for Hand Hygiene ’ program specifies that healthcare workers should perform hand hygiene before patient contact , before aseptic tasks , after exposures to patients ’ bodily fluids , after contact with patients , and after contact with objects and surfaces in the patient care area . However , different patient-care task types and the contacts involved in these tasks present substantially different risks to both healthcare workers and patients . Consequently , task transitions vary in their risk of transmitting pathogens to patients , their invasive devices , and their environment if healthcare workers do not perform hand hygiene .”
Chang and Jones , et al . ( 2021 ) consulted infection preventionists for assistance in ranking clinical tasks by both the risk to the patient if the healthcare worker did not perform hand hygiene and the risk of healthcare worker hand contamination : “ Compared with other tasks , clean tasks posed a higher risk to patients if healthcare workers did not perform hand hygiene before performing the task and had a lower risk of healthcare worker hand contamination . Dirty tasks had a higher risk of healthcare worker hand contamination but a lower risk for the patient if healthcare workers did not perform hand hygiene before the task . The task classification could vary by the task transition . For example , tasks during which the healthcare worker touched the environment would have a relatively lower risk of contaminating