| Abstract |
Introduction: Hand hygiene is one of the main factors for the prevention of hospital-acquired infections. Although there have been studies on whether healthcare workers aly the hand hygiene technique correctly (or not at all) there has been no investigation into whether the courses are effective as an intervention to change the attitude of healthcare professionals regarding the alication of hand hygiene technique in order to achieve a reduction in the spread of hospital-acquired infections.
Purpose: The purpose of this study was to investigate the effectiveness of educational courses as a measure to correct the behavior of health professionals in hygiene measures for the prevention the of hospital-acquired infections transmission.
Method: It is a cross-sectional intervention study where the evaluation was made by direct observation. The study took place at the Chania General Hospital. The study population included the medical, nursing and suort staff. The study was done in 3 phases. In the 1st one , the compliance of the participants in the HY was evaluated by direct observation using the specialized alication "SpeedyAudit Lite". In phase B, the procedure followed was: determination of the existing knowledge with an anonymous self-completed WHO questionnaire "5 moments for Hand Hygiene (HH)". It was followed by micro-lecture and use of the "Derma LiteCheck Box" educational device of the HARTMANN Scientific Center. Finally, the improvement of knowledge was assessed by completing the same questionnaire after the completion of the microlecture . In the 3rd phase, there was again a direct monitoring of the implementation of the HH during the performance of medical and nursing interventions.
Results: In the 1st phase, 570 records of compliance to the HH rules were recorded with equal participation both of doctors (43.2%) and nurses (43.7%). The vast majority (86.2%) did not perform hand hygiene, while 9% washed hands with soap and water, and 4.8% used an antiseptic. Of the small sample that performed hand hygiene, 23.6% did it before and 21.5% after contact with the patient, 22.9% after contact with the environment of the patient, 18% before aseptic technique and 13.9% after contact with biological fluids. The higher number of registrations were made in the Department of Pediatrics 30.9% and the fewest (0.7%) in the A΄/B΄ Department of Internal Medicine. Most of the participants used the same pair of gloves for all patients in the ward without removing them and then alying XY. This finding continued in the 3rd phase
In phase B, 262 professionals (80.4% women) completed the questionnaire before and 244 after the lecture. The highest score of knowledge as defined by the number of correct answers was 25. The participants achieved higher score (average=17.37± 3,144) after training compared to the one before (mean13.65± 3,06). 73.9% of A number of people have training - education in HH during the last 3 years. Men and women showed similar score and the older a person the lower the knowledge score and vice versa. Finally, it is worth mentioning that the level of knowledge of doctors both before and after training is higher than that of nursing staff.
In the 3rd phase, 1264 records were made and 64.5% of them were nurses while 25.7% were doctors. An impressive 83.3% again, did not perform HH, 9.2% used antiseptic and 7.5% washed their hands with soap and water The majority performed HH before (31%), and after (30.7%) contact with the patient, 16% after contact with the environment, 11.6% after contact with biological fluids and 10.7% before aseptic technique. In completing the questionnaire before and after (94.3% and 93.9% respectively) the training sessions, it aeared that the participants were aware that artificial nails and the use of jewelry are associated with increased chance of hand colonization with pathogenic microbes. However, in both A' and C' phases of surveillance, 30.2% vs 54% respectively of the staff had artificial nails, 14% vs 52% wore rings and 36.1% vs 33% bracelets. mask compliance was High before (98.7%) and after (94.1%) the training sessions. This is more likely due to the implementation of the strict measures regarding the spread of the SARS-COV-2 coronavirus in the health units, than the attitude of the health personnel related to the prevention of infections, indicative of the importance of surveillance for the implementation of the directives. At the same time and in exaggeration, the high protection mask was alied for no reason
Conclusions: After the training sessions, despite the fact the more correct answers were given to the questionnaire for knowledge evaluation, the compliance rate was not improved. It is concluded that educational programs albeit necessary to inform and update the knowledge of healthcare professionals, they are not sufficient by themselves to modify the attitude of personnel to implement hygiene measures and prevent transmission of nosocomial infections
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