Compliance with a novel hand hygiene protocol tailored to non-sterile healthcare workers in the operating theatre

M. D. van Dijk*, C. M. Waltmans-den Breejen, Cooperating Rijnmond Hospitals, J. M.J.J. Vermeeren, S. van den Berg, E. F. van Beeck, M. C. Vos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Observing hand hygiene compliance (HHC) among non-sterile healthcare workers (HCWs) in the operating theatre (OT) is challenging as there are no tailored protocols or observation tools. Aim: To develop and test a hand hygiene protocol tailored to non-sterile HCWs in the OT. Methods: In this prospective observational study, nine hospitals in the Rotterdam-Rijnmond region provided input on a draft protocol on hand hygiene in the OT, resulting in a new consensus protocol for the region. An observation tool based on the protocol was developed and tested. HHC rates with 95% confidence intervals (CI) were calculated by type of hospital and type of HCW. Findings: The protocol has three sections: (1) written general hand hygiene rules; (2) written hand hygiene rules specific for anaesthesia and surgery; and (3) visual representation of the OT, divided into four hand hygiene areas. Hand hygiene should be applied when changing area. Average HHC of 48.0% (95% CI 45.2–61.2%) was observed in OTs across all hospitals. HHC was highest in the two specialized hospitals (64.0%, 95% CI 30.6–89.8%; 76.7%, 95% CI 62.8–84.5%) and lowest in the academic teaching hospital (23.1%, 95% CI 0.0–45.8%). In terms of type of HCW, HHC was lowest among anaesthesiologists (31.6%, 95% CI 19.2–62.4%) and highest among OT assistants (57.4%, 95% CI 50.1–78.2%). Conclusion: This uniform way of observing HHC in the OT enables evaluation of the effectiveness of interventions in the OT and facilitates friendly competition. In the Rotterdam-Rijnmond region, HHC in the OT was below 50%; this needs to be addressed, particularly in teaching hospitals and among physicians.

Original languageEnglish
Pages (from-to)173-180
Number of pages8
JournalJournal of Hospital Infection
Publication statusPublished - 1 Jan 2023

Bibliographical note

Funding Information:
This study is part of ongoing surveillance programmes supported and funded by SRZ. However, the Board of Directors of SRZ were in no way involved in the data management, data analysis or writing of the manuscript.

Publisher Copyright:
© 2022 The Author(s)


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