Factors associated with personal protection equipment use and hand hygiene among hemodialysis staff.
BACKGROUND
Because exposure to blood by health care workers is frequent during hemodialysis, gloves are required for all contact with patients and their equipment, followed by hand hygiene. In this study, we investigated factors associated with performing these practices as recommended.


METHODS
Staff members from a sample of 45 US hemodialysis facilities were surveyed using an anonymous self-administered questionnaire. Factors independently associated with reporting increased compliance with recommended hand hygiene and glove use practices during patient care were identified with multivariate modeling.


RESULTS
Of 605 eligible staff members, 420 (69%) responded: registered nurses, 41%; dialysis technicians, 51%; and licensed practical nurses, 8%. Only 35% reported that dialysis patients were at risk for bloodborne virus infections, and only 36% reported always following recommended hand hygiene and glove use practices. Independent factors associated with more frequent compliance were being a technician (versus a registered nurse) and reporting always doing what was needed to protect themselves from infection.


CONCLUSIONS
Compliance with recommended hand hygiene and glove use practices by hemodialysis staff was low. The rationale for infection control practices specific to the hemodialysis setting was poorly understood by all staff. Infection control training should be tailored to this setting and should address misconceptions.
Shimokura
Gayle
G
Department of Epidemiology, UNC School of Public Health, Chapel Hill, NC, USA. gshim@shaw.ca
Weber
David J
DJ
Miller
William C
WC
Wurtzel
Heather
H
Alter
Miriam J
MJ
D001294:Attitude to Health; D005260:Female; D017575:Gloves, Protective / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods*; D006436:Hemodialysis Units, Hospital; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000379:methods*; D008297:Male; D010564:Personnel, Hospital / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States