Analysis: Hand Hygiene Compliance in Healthcare Settings

This report provides a comprehensive summary of an article published in the International Journal of Infectious Diseases in 2013, focusing on hand hygiene compliance among healthcare workers in intensive care units at Aseer Central Hospital in Saudi Arabia. The study, conducted using WHO-recommended observation methods across four ICUs, revealed a concerning 41% non-compliance rate. Non-compliance was highest among physicians, particularly before aseptic procedures. The article discusses the implications of this non-compliance, linking it to increased healthcare-associated infections, higher costs, and increased mortality and morbidity rates. The study's findings were compared to other similar studies and global data, highlighting the impact of factors such as staff turnover, religious beliefs, and the challenges of standardizing practices. The authors recommend increased education to promote a culture of hand washing among healthcare workers, emphasizing the need for improved compliance to reduce the spread of infections.

Running head: PRESENTING ACADEMIC DISCOURSE 1
Article Summary of the International Journal of Infectious Disease
Name of Student
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PRESENTING ACADEMIC DISCOURSE 2
Article Summary of the International Journal of Infectious Disease
The summary is derived from an article published in the International Journal of
Infectious Diseases of 2013, by Ahmed Mahfouz, Mohammad Gamal and Taril Al-Azraqi. The
main focus of the article is on the research they undertook to gauge the compliance or its lack
thereof regarding hand hygiene compliance amongst healthcare workers. This particular study
focused on healthcare workers working in intensive care units at the Aseer Central Hospital
located in the southern region of Saudi Arabia. The article is presented in two parts: the first
covers the methodology and findings and is followed by the discussion of the results.
Methodology
The sample size used was a total of 500 observations that used four ICUs: main ICU with
12 beds, intermediate care unit (IMCU with 32 beds), pediatric unit (PICU with 7 beds) and the
cardiac unit (CCU with 15 beds). The observations made focused on the WHO recommended
method of observation. These include the moment before making contact with the patient, before
a procedure that is aseptic, after risk of exposure to bodily fluids, after touching a patient and
after touching the surrounding of the patient (Mahfouz, Gamal & Al-Azraqi, 2013). The
observations were recorded by infection control nurses who had earlier been trained. It covered
179 nurses, 34 physicians and 23 assorted health care workers who worked in the above units.
Findings
The main outcome that was measured was the non-compliance of washing hands by the
healthcare workers at different moments. The data was measured and analyzed using different
statistical tools in order to validate the collected observations. The total overall percentage of
non-compliance stood at 41%. Non-compliance was highest amongst physicians when compared
to nurses and other healthcare workers. This was high after contact with patients and their
surroundings (Mahfouz, Gamal & Al-Azraqi, 2013). The lack of compliance increased from

PRESENTING ACADEMIC DISCOURSE 3
16.9% after caring for the patient, to 59.3% before contact with patient. It was highest at 72.7%
before a procedure that aseptic.
Discussion
The overall rate of non-compliance stood at 41% in all ICS’s. The discussion focused on
the linkage between the non-compliance in hand washing and healthcare associated infections.
These infections significantly contribute to increased costs and time spent in hospitals. It also
increases the hospital mortality and morbidity rates (Mahfouz, Gamal & Al-Azraqi, 2013). The
high percentage of non-compliance at the hospital was attributed to the high turn-over
experienced and this was supported by the findings of a similar report published in 2007.Simialr
studies done at the University Hospital in Riyadh revealed a much higher rate which stood at
58%. The results of the study validated the global findings that showed non-compliance stood at
60-70%.
The specific findings show that compliance to wash hands was high when the healthcare
workers observed that their hands were sticky or dirty. The sites with the highest risk were found
to be those next to the patient such as lockers. Doctors were found to be lower in compliance and
generally considered as ‘difficult’ by resisting imposed standardized rules and practices
(Mahfouz, Gamal & Al-Azraqi, 2013). The impact of religion also contributed to the low
compliance with regards to alcohol-based hand disinfectants. There is however an increased
awareness and use of such alcohol based cleansers. The authors concluded by recommending
that there should be increased education that promotes the culture of hand washing amongst
healthcare workers.

PRESENTING ACADEMIC DISCOURSE 4
References
Mahfouz, A., Gamal, M., Al-Azraqi, T. (2013). Hand hygiene non-compliance among intensive
care unit Healthcare workers in Aseer Central Hospital, South-Western Saudi Arabia,
International Journal of Infectious Disease. Retrieved from
http://www.elsevier.com/locate/ijid