Adherence to Hand Hygiene Protocols in Two Hospitals in the Volta Region

Abstract

Background: Hand hygiene has been proven to be an effective way of ridding the hands of harmful pathogens which can be transmitted from person to person resulting in infection leading to morbidity and mortality. Newborns are particularly susceptible to infections due to their under developed immune system, a third of all neonatal mortality being due to infections. In Ghana, neonatal mortality remains high with the Volta Region having the highest neonatal mortality among the regions. National guidelines have been developed for Infection Prevention and Control which outline the objectives, techniques and benefits of hand hygiene in the health care setting and also include monitoring guides and schedules. However, adherence remains low among health care workers worldwide. This study aimed to evaluate adherence to hand hygiene of health care workers in two hospitals in the Volta Region of Ghana. Methods: The study was a cross sectional study centred on wards which handled neonates and involved a self-administered questionnaire on hand hygiene, observations of hand hygiene and ward infrastructure surveys using the WHO tools. Results: A total of 119 respondents from both maternity wards and neonatal units were surveyed and observed comprising doctors (11%), nurses (40%), midwives (28%) and students of all categories (21%). There was no difference in mean compliance from the maternity units from the mean compliance from the neonatal units (t (117) = 1.28, p > 0.05). There was no statistically significant difference between the mean adherence levels between the different categories of staff [F (2, 116) = 0.05, p> 0.05]. There was no relationship between knowledge and adherence (χ2 =24, p>0.05). The main reasons for non-adherence were forgetfulness, inadequate supplies and because of emergencies or high workload. The overall hand hygiene adherence score in Battor Catholic Hospital of 69.29% and that of Ho Teaching Hospital was 71.13%. The most used method of hand hygiene was hand washing with exposure to body fluids being the most adhered to reason for hand hygiene. Conclusion: Provision of hand hygiene supplies may increase hand hygiene adherence and more reminders in the workplace may increase hand hygiene compliance in the wards. Although frequent training in hand washing is useful, the knowledge gained does not translate into increased adherence to the hand hygiene protocols.