title: Hand contamination during routine care in medical wards: the role of hand hygiene compliance.
abstract: The hands of healthcare workers (HCWs) are the most common vehicle for the transmission of micro-organisms from patient to patient and within the healthcare environment. The aim of this study was to evaluate the impact of a multimodal campaign on the type and amount of resident and transient flora and the presence of potential risk factors for hand contamination during routine care. A before-after (PRE and POST periods) interventional study was carried out in medical wards of a tertiary care hospital. Eighty-nine samples were analysed. Samples were cultured immediately before patient contact using a glove-juice method. Data collected included socio-demographic and risk factors for hand contamination. Flora was measured as log10 c.f.u. ml(-1) and evaluated by comparing median values in the PRE and POST periods. Transient flora was isolated from the hands of 67.4 and 46.1 % of HCWs in the PRE and POST periods, respectively (P<0.001). Enterobacteriaceae, Pseudomonas spp. and meticillin-sensitive Staphylococcus aureus were the predominant contaminants. Resident flora was isolated from 92.1 % of HCWs in the PRE period and from 70.8 % in the POST period (P<0.001). The meticillin-resistant coagulase-negative staphylococci log10 c.f.u. count ml(-1) decreased from 1.96 ± 1.2 to 0.89 ± 1.2 (mean ± s d; P<0.001), and the global flora count decreased from 2.77 ± 1.1 to 1.56 ± 1.4 (P<0.001). In the POST period, the wearing of fewer rings (P<0.001), shorter fingernail length (P = 0.008), a shorter time since recent hand hygiene (HH) (P = 0.007) and an increased use of alcohol-based hand rub instead of soap (P<0.001) were documented. The HH multimodal strategy reduced the number of risk factors and the level of HCW hand contamination.
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Olga
authors: O
authors: Monistrol
authors: Catlab, Parc Logístic de Salut, Vial de Sant Jordi s/n Viladecavalls, Barcelona, Spain.
authors: M Liboria
authors: ML
authors: López
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Montserrat
authors: M
authors: Riera
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Roser
authors: R
authors: Font
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Carme
authors: C
authors: Nicolás
authors: Nursing Faculty, Campus de Ciències de la Salut, University of Lleida, Avinguda de l'Alcalde Rovira Roure, 44, E-25198 Lleida, Spain.
authors: Miguel Angel
authors: MA
authors: Escobar
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Núria
authors: N
authors: Freixas
authors: Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Javier
authors: J
authors: Garau
authors: Campus Sant Cugat, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.|Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain.
authors: Esther
authors: E
authors: Calbo
mesh_terms: D000328:Adult; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D005260:Female; D019983:Guideline Adherence; D006225:Hand / Q000382:microbiology*; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged