title: Unit-Specific Rates of Hand Hygiene Opportunities in an Acute-Care Hospital.
abstract: OBJECTIVE To explore the frequency of hand hygiene opportunities (HHOs) in multiple units of an acute-care hospital. DESIGN Prospective observational study. SETTING The adult intensive care unit (ICU), medical and surgical step-down units, medical and surgical units, and the postpartum mother-baby unit (MBU) of an academic acute-care hospital during May-August 2013, May-July 2014, and June-August 2015. PARTICIPANTS Healthcare workers (HCWs). METHODS HHOs were recorded using direct observation in 1-hour intervals following Public Health Ontario guidelines. The frequency and distribution of HHOs per patient hour were determined for each unit according to time of day, indication, and profession. RESULTS In total, 3,422 HHOs were identified during 586 hours of observation. The mean numbers of HHOs per patient hour in the ICU were similar to those in the medical and surgical step-down units during the day and night, which were higher than the rates observed in medical and surgical units and the MBU. The rate of HHOs during the night significantly decreased compared with day (P92% of HHOs on medical and surgical units, compared to 67% of HHOs on the MBU. CONCLUSIONS Assessment of hand hygiene compliance using product utilization data requires knowledge of the appropriate opportunities for hand hygiene. We have provided a detailed characterization of these estimates across a wide range of inpatient settings as well as an examination of temporal variations in HHOs. Infect Control Hosp Epidemiol 2017;38:411-416.
authors.affiliation: 1Faculty of Medicine,University of Toronto,Toronto,Ontario,Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Han
authors.affiliation: 3Lawrence S. Bloomberg Faculty of Nursing,University of Toronto,Toronto,Ontario,Canada.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Conway
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Moore
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Liz
authors.initials: L
authors.lastname: McCreight
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Ragan
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Jannice
authors.initials: J
authors.lastname: So
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Borgundvaag
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Mike
authors.initials: M
authors.lastname: Larocque
authors.affiliation: 4Dalla Lana School of Public Health,University of Toronto,Toronto,Ontario,Canada.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Coleman
authors.affiliation: 2Division of Infection Control,Mount Sinai Hospital,Toronto,Ontario,Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
mesh_terms: D063373:Hand Hygiene / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors; D014789:Visitors to Patients / Q000706:statistics & numerical data