title: Differences in hand hygiene behavior related to the contamination risk of healthcare activities in different groups of healthcare workers.
abstract: BACKGROUND
  The Fulkerson scale lists 15 typical clinical activities ranked according to their risk of hand contamination.
  
  
  OBJECTIVE
  To investigate how often healthcare workers (HCWs) apply antiseptic handrubs after each of the specified activities ranked in the Fulkerson scale.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  University Hospital of Heidelberg, a 1,600-bed teaching hospital.
  
  
  METHODS
  Using a structured protocol, 41 observers recorded whether HCWs rubbed their hands in 1 of 15 given situations.
  
  
  RESULTS
  Handrubs were used in 1,115 (52.2%) of 2,138 observations. Comparatively high rates of handrub use were observed after contact with sterile materials (39.6%) and after contact with excretions (90% to 97%). Nurses used handrubs significantly more frequently than did physicians after contact with the inanimate environment, but physicians applied handrubs significantly more frequently after contact with body secretions.
  
  
  CONCLUSIONS
  This study showed better compliance with hand hygiene than that reported by many previous studies, but compliance was still inadequate and varied significantly by type of HCW, type of activity, and location in the hospital.
authors.affiliation: Hygiene-Institut der Universität Heidelberg, Heidelberg, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Wendt
authors.forename: Donald
authors.initials: D
authors.lastname: Knautz
authors.forename: Heike
authors.initials: H
authors.lastname: von Baum
mesh_terms: D000438:Alcohols / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D005858:Germany; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000592:standards*; D006785:Hospitals, University; D006801:Humans; D006920:Hygiene / Q000592:standards*; D017053:Infection Control / Q000379:methods / Q000592:standards*; D017757:Infectious Disease Transmission, Professional-to-Patient; D008505:Medical Staff, Hospital / Q000592:standards / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000592:standards / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012867:Skin / Q000382:microbiology
chemical_list: D000438:Alcohols; D000891:Anti-Infective Agents, Local