title: Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities.
abstract: BACKGROUND
  Health care-associated infection remains a significant hazard for hospitalized patients. Hand hygiene is a fundamental action for ensuring patient safety.
  
  
  OBJECTIVE
  To promote adoption of World Health Organization Hand Hygiene Guidelines to enhance compliance among doctors and nurses and improve patient safety.
  
  
  METHODS
  The study design was a cross sectional intervention in a Federal Teaching Hospital South-eastern Nigeria. Interventions involved training/education; introduction of hand rub; and hand hygiene reminders. The impact of interventions and hand hygiene compliance were evaluated using World Health Organization direct observation technique.
  
  
  RESULTS
  The post-intervention hand hygiene compliance rate was 65.3%. Hand hygiene indications showed highest compliance rate 'after body fluid exposure' (75.3%) and 'after touching a patient' (73.6%) while the least compliance rate was recorded 'before touching a patient' (58.0%). Hand hygiene compliance rate was significantly higher among nurses (72.9%) compared to doctors (59.7%) (χ(2)=23.8, p<0.05). Hand hygiene indication with significantly higher compliance rate was "before clean/aseptic procedure" (84.4%) (χ(2)=80.74, p<0.05). Out of the 815 hand hygiene practices recorded 550 (67.5%) were hand rub action.
  
  
  CONCLUSIONS
  hand hygiene campaigns using the World Health Organization tools and methodology can be successfully executed in a tertiary health facility of a low-income setting with far reaching improvements in compliance.
authors.affiliation: Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria. Electronic address: unekecj@yahoo.com.
authors.forename: Chigozie Jesse
authors.initials: CJ
authors.lastname: Uneke
authors.affiliation: Department of Community Medicine, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria.
authors.forename: Chinwendu Daniel
authors.initials: CD
authors.lastname: Ndukwe
authors.affiliation: Department of Community Medicine, Faculty of Clinical Medicine, Delta State University, Abraka, Nigeria.
authors.forename: Patrick Gold
authors.initials: PG
authors.lastname: Oyibo
authors.affiliation: Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria.
authors.forename: Kingsley Onuoha
authors.initials: KO
authors.lastname: Nwakpu
authors.affiliation: Department of Community Medicine, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria.
authors.forename: Richard Chukwuka
authors.initials: RC
authors.lastname: Nnabu
authors.affiliation: The World Health Organization Patient Safety Research Programme, Switzerland.
authors.forename: Nittita
authors.initials: N
authors.lastname: Prasopa-Plaizier
mesh_terms: D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards; D006268:Health Facilities; D006282:Health Personnel / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D007318:Inservice Training; D008505:Medical Staff, Hospital; D009549:Nigeria; D009741:Nursing Staff, Hospital; D061214:Patient Safety / Q000592:standards*; D014944:World Health Organization
keywords: Compliance; Hand hygiene; Health worker; Patient safety
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