Assessment of nurses' hand hygiene practices in primary health care clinics of eThekwini Municipality

Abstract

Background Hands of heath care workers are known to be the main vehicle in the transmission of infectious agents in the health care setting. Hand hygiene is an essential, cheap, simple, effective and the corner stone in infection and control strategies, and it plays a major role in reduction of health care associated infections. The focus on hand hygiene has been hospital based because of the health care associated infections within those settings. The high utilization of the primary health care (PHC) clinics, the complexity and comprehensiveness of the services rendered in PHC clinics, the more invasive procedures that are being performed in PHC clinics and the studies on hand hygiene that were focused mainly in hospitals setting motivated the study on the assessment of hand hygiene practices in PHC clinics.

Aim of the study The aim of the study was to assess hand hygiene practices of nurses in the PHC facilities of eThekwini municipality.

Methodology This study was a descriptive, observational and survey study design in a quantitative paradigm, conducted in three PHC clinics with high caseload. The non-probability, purposive sampling method was used to select PHC clinics. The study population were the nurses from the three selected PHC clinics. An adapted Infection Control Self-Assessment Tools for PHC Facilities was used to collect data. An adapted self-reported World Health Organisation Hand Hygiene Knowledge Questionnaire for Health Care Workers Assessment Tool was used to assess knowledge and training in hand hygiene. Data was analysed using SPSS version 22.0. Inferential statistics were used to determine the relationship between the variables.

Results The results showed that in all the three PHC clinics, hand hygiene was performed more frequently after contact with patients than before contact with patients in both invasive and non-invasive procedures. The commonly used method of hand hygiene was hand rubbing with alcohol hand rub than hand washing. In observing whether the hand rubbing steps were followed, this was done significantly less than half the time (p=<.0005). The average knowledge score across all questions was 73.64% and there was no significant correlation between knowledge and percentage of time using HH.