title: Hand washing and use of gloves while managing patients receiving mechanical ventilation in the ICU.
abstract: OBJECTIVE
  To evaluate the effectiveness of warning labels permanently attached to mechanical ventilators in improving the practice of hand washing and use of gloves by respiratory care practitioners (RCPs) in the ICU.
  
  
  METHODS
  The study consisted of two 4-week periods. Daily observations of hand washing and use of gloves by RCPs were made over four 1-h observation periods. Prior to the first 4-week period, the importance of hand washing and use of gloves was presented to all staff. At the end of the first period, "Wash Hands Use Gloves" labels were permanently placed on all ventilators in the ICU. The RCPs were not aware they were being observed for hand washing and use of gloves in either period.
  
  
  RESULTS
  The total number of encounters between the RCPs and patients as well as the rates of hand washing and use of gloves were obtained during the study. The rates of hand washing and use of gloves were significantly higher during the second period when labels were attached to the ventilators, as compared to the rates during the first period: hand washing, 92% vs 46% (p < 0.05); use of gloves, 92% vs 43% (p < 0.05), respectively. During the first period, the rates of pre-encounter hand washing (78%, 48%, 27%, and 29% in weeks 1 through 4, respectively) and the use of gloves (56%, 37%, 32%, and 45% in weeks 1 through 4, respectively) were primarily declining. This was not observed during the second period of the study (94%, 88%, 95%, and 92% in weeks 1 through 4, respectively) for the rates of pre-encounter hand washing and the use of gloves.
  
  
  CONCLUSIONS
  Simple measures such as the placement of warning labels on mechanical ventilators can significantly improve hand washing and use of gloves by RCPs in the ICU.
authors.affiliation: Department of Anesthesiology, School of Medicine, American University of Beirut, Lebanon. mk05@aub.edu.lb
authors.forename: M
authors.initials: M
authors.lastname: Khatib
authors.forename: G
authors.initials: G
authors.lastname: Jamaleddine
authors.forename: A
authors.initials: A
authors.lastname: Abdallah
authors.forename: Y
authors.initials: Y
authors.lastname: Ibrahim
mesh_terms: D000488:Allied Health Personnel; D003428:Cross Infection / Q000517:prevention & control*; D017575:Gloves, Protective / Q000706:statistics & numerical data*; D006235:Hand Disinfection; D006801:Humans; D007362:Intensive Care Units; D012121:Respiration, Artificial; D012122:Ventilators, Mechanical