Connaissance et perception de l'hygiène des mains Internes d ...

© World Health Organization 2009. All rights reserved.

Slide 1

Data Summary Report Framework

Revised October 2009

Slide 2

User instructions (1)

■ This presentation is intended to give some examples of how best to present the results of the surveys performed during the evaluation phases of the implementation of the hand hygiene improvement strategy

■ The presented results can refer to the entire facility (hospital-wide) or can be related to the unit, service or ward where the data were collected

■ These results can be reported to staff, to explain the current practices, knowledge and perception of hand hygiene in their health-care setting and to highlight the aspects that need improvement, or to compare baseline with follow-up data to show possible improvements resulting from the range of efforts made

Slide 3

User instructions (2)

■ The local data must be inserted in the template presentation■ The template includes reporting of the knowledge survey, the

perception surveys (for health-care workers and senior managers) and the hand hygiene observation survey

■ Correct answers where provided by WHO are written in this colour

■ Slides 84 to 88 are examples of comparisons between baseline and follow-up measurements

■ Data for the slides can be generated using data-entry and data-analysis in Epi InfoTM (available at: http://www.who.int/gpsc/5may/tools/evaluation_feedback/en/index.html)

http://www.who.int/gpsc/5may/tools/evaluation_feedback/en/index.html


Slide 4

Results of the Hand Hygiene Knowledge Questionnaire for Health-Care Workers

(Name of facility)

Slide 5

Methods

■ Distribution of the WHO “Hand Hygiene Knowledge Questionnaire for Health-Care Workers” to health-care workers in identified clinical settings

■ Data entry and analysis using the Data Entry Analysis Tools

■ Use of this presentation to provide feedback

Slide 6

Q8–9. Participants’ characteristics

■ Total number of participants:■ Gender:

Female: (%)Male: (%)

■ Age:Median: + interquartile rangeMean: ± standard deviation (SD)(Median and range are preferred as they represent

centrality and spread of not normally distributed data)

Slide 7

Q 10. Profession

Profession Number (%)

Nurse

Auxiliary nurse

Midwife

Medical Doctor

Resident

Technician

Therapist

Nurse student

Medical student

Other

Slide 8

Q11. Department

Department Number (%)Internal medicine

Surgery

Intensive care unit

Mixed medical/surgical

Emergency unit

Obstetrics

Paediatrics

Long-term/rehabilitation

Outpatient clinic

Other

Slide 9

Q12–13. Hand hygiene training and availability of alcohol-based handrub

■ Formal training in hand hygiene: number (%)■ Do you routinely use an alcohol-based handrub for hand

hygiene?: number (%)

Slide 10

Q14. Which of the following is the main route of cross-transmission of potentially harmful germs between patients in a health-care facility?

■ HCWs’ hands when not clean: number (%) ■ Air circulating in the hospital: number (%)■ Patients’ exposure to colonised surfaces: number (%)■ Sharing non-invasive objects (i.e. stethoscopes, pressure

cuffs, etc.) between patients: number (%)

Slide 11

Q15. What is the most frequent source of germs responsible for health care-associated infections?

■ The hospital’s water system: number (%)■ The hospital air: number (%)■ Germs already present on or within the patient:

number (%)■ The hospital environment (surfaces): number (%)

Slide 12

Q16. Which of the following hand hygiene actions prevents transmission of germs to the patient? Action Yes No

Before touching a patient (%) (%)

Immediately after a risk of body fluid exposure (%) (%)

Immediately before a clean/aseptic procedure (%) (%)

After exposure to the immediate surroundings of a patient (%) (%)

Slide 13

Q17. Which of the following hand hygiene actions prevents transmission of germs to the health-care worker?

Action Yes No

After touching a patient (%) (%)

Immediately after a risk of body fluid exposure (%) (%)

Immediately before a clean/aseptic procedure (%) (%)

After exposure to the immediate surroundings of a patient (%) (%)

Slide 14

Q18. Which of the following statements on alcohol-based handrub and hand washing with soap and water are true? Statement True False

Handrubbing is more rapid for hand cleansing than handwashing (%) (%)

Handrubbing causes skin dryness more than handwashing (%) (%)

Handrubbing is more effective against germs than handwashing (%) (%)

Handwashing and handrubbing are recommended to be performed in sequence

(%) (%)

Slide 15

Q19. What is the minimal time needed for alcohol-based handrub to kill most germs on your hands?

■ 20 seconds: (%)■ 3 seconds: (%)■ 1 minute: (%)■ 10 seconds: (%)

Slide 16

Q20. Which type of hand hygiene method is required in the following situations?

Situation Rubbing Washing None

Before palpation of the abdomen (%) (%) (%)

Before giving an injection (%) (%) (%)

After emptying a bedpan (%) (%) (%)

After removing examination gloves (%) (%) (%)

After making a patient's bed (%) (%) (%)

After visible exposure to blood (%) (%) (%)

Slide 17

Percentage of correct answers to question 20

0

20

40

60

80

100

Beforepalp

Beforeinjection

Afterbedpan

Aftergloves

Afterpatient's

bed

Afterblood

Situations requiring hand hygiene

%

Slide 18

Q21. Which of the following should be avoided, as associated with a likelihood of colonisation of hand with harmful germs?

Likelihood of hand colonization Yes No

Wearing jewellery (%) (%)

Damaged skin (%) (%)

Artificial fingernails (%) (%)

Regular use of a hand cream (%) (%)


Slide 19

Conclusions and recommended actions:

To be inserted locally.


Slide 20

Results of the Perception Survey for Health-Care Workers (Name of facility)

Slide 21

Methods

■ Distribution of the WHO “Perception Survey for Health-Care Workers" to health-care workers in identified clinical settings



Slide 22

Q8-9. Participants’ characteristics



■ Age:Median: + interquartile rangeMean: ± standard deviation (SD)(Median and range are preferred as they represent

centrality and spread of not normally distributed data)

Slide 23

Q 10. Profession

Profession Number (%)

Nurse

Auxiliary nurse

Midwife

Medical Doctor

Resident

Technician

Therapist

Nurse student

Medical student

Other

Slide 24

Q11. Department

Department Number (%)Internal medicine

Surgery

Intensive care unit

Mixed medical/surgical

Emergency unit

Obstetrics

Paediatrics

Long-term/rehabilitation

Outpatient clinic

Other

Slide 25

Q12–13. Hand hygiene training and availability of alcohol-based handrub

■ Formal training in hand hygiene: number (%)■ Do you routinely use an alcohol-based handrub for hand

hygiene?: number (%)

Slide 26

Q14. In your opinion, what is the average rcentage of hospitalised patients who will develop a health care-associated infection (HCAI)?

0-10 11-20 21-3031-40

41-50

51-60

61-70

71-80

81-90

91-100

0

20

40

60

80

100

%

Percentage of hospitalized patients developing a HCAI

Slide 27

Q15. In general, what is the impact of a health care-associated infection on a patient's clinical outcome?

■ Very low: number (%)■ Low: number (%)■ High: number (%)■ Very high: number (%)

Slide 28

Q16. What is the effectiveness of hand hygiene in preventing health care-associated infection?

■ Very low: number (%)■ Low: number (%)■ High: number (%)■ Very high: number (%)

Slide 29

Q17. Among all patient safety issues, how important is hand hygiene at your institution?

■ Low priority: (%)■ Moderate priority: (%)■ High priority: (%)■ Very high priority: (%)

Slide 30

Q18. On average, in what percentage of situations requiring hand hygiene do health-care workers in your hospital actually perform hand hygiene?

0-1011-20

21-30

31-4041-50 51-60

61-7071-80 81-90

91-100

0

20

40

60

80

100

%

percentage of situations health-care workers perform hand hygiene when required


Slide 31

Q19.

In your opinion, how effective would the following actions be to improve hand hygiene permanently in your institution?

Slide 32

Q19.a. Leaders and senior managers at your institution support and openly promote hand hygiene

0

20

40

60

80

100

Noteffective

2 3 4 5 6 Veryeffective

%

Slide 33

Q19.b. The health-care facility makes alcohol-based handrub always available at each point of care

0

20

40

60

80

100

Noteffective


%

Slide 34

Q19.c. Hand hygiene posters are displayed at point of care as reminders

0

20

40

60

80

100

Noteffective


%

Slide 35

Q19.d. Each health-care worker receives education on hand hygiene

0

20

40

60

80

100

Noteffective


%

Slide 36

Q19.e. Clear and simple instructions for hand hygiene are made visible for every health-care worker

0

20

40

60

80

100

Noteffective


%

Slide 37

Q19.f. Health-care workers regularly receive feedback on their hand hygiene performance

0

20

40

60

80

100

Noteffective


%

Slide 38

Q19.g. You always perform hand hygiene as recommended (being a good example for your colleagues)

0

20

40

60

80

100

Noteffective


%

Slide 39

Q19.h. Patients are invited to remind health-care workers to perform hand hygiene

0

20

40

60

80

100

Noteffective


%

Slide 40

Q20. What importance does the head of your department attach to the fact that you perform optimal hand hygiene?

0

20

40

60

80

100

Noimportance

2 3 4 5 6 Very highimportance

%

Slide 41

Q21. What importance do your colleagues attach to the fact that you perform optimal hand hygiene?

0

20

40

60

80

100

Noimportance


%

Slide 42

Q22.What importance do patients attach to the fact that you perform optimal hand hygiene?

0

20

40

60

80

100

Noimportance


%

Slide 43

Q23. How do you consider the effort required by you to perform good hand hygiene when caring for patients?

0

20

40

60

80

100

No effort 2 3 4 5 6 A bigeffort

%

Slide 44

Q24. On average, in what percentage of situations requiring hand hygiene do you actually perform hand hygiene, either by handrubbing or handwashing?

0-1011-20 21-30 31-40

41-50

51-60

61-70

71-80

81-9091-100

0

20

40

60

80

100

%

Percentage of situations where you perform hand hygiene when required


Slide 45

Conclusions and recommended actions:



Slide 46

Results of the Perception Survey for Senior Managers

(Name of facility)

Slide 47

Methods

■ Distribution of the WHO “Perception Survey for Health-Care Workers" to health-care workers in identified clinical settings



Slide 48

Q5. Participants’ characteristics



Slide 49

Q6–8. Participants’ characteristics

■ Time spent in current position:■ Time spent in present institution:■ Current position(s):

Director: (%)Head nurse: (%)Head physician: (%)Hospital administrator: (%)

Slide 50

Q9–10. Hand hygiene campaign and availability of alcohol-based handrub

■ Have you had any previous experience of a hand hygiene campaign: number (%)

■ Is an alcohol-based formulation available for hand hygiene at your facility: number (%)

Slide 51

Q11. In your opinion, what is the average percentage of hospitalised patients who will develop a health care-associated infection?

0 5 10 1520

25

30

35

40

45 5060

0

20

40

60

80

100

%

Percentage of hospitalized patients developing a HCAI

Slide 52

Q12. In general, what is the impact of a health care-associated infection on patient's clinical outcome?

■ Very low: (%)■ Low: (%)■ High: (%)■ Very high: (%)

Slide 53

Q13. In general, what is the impact of a health care-associated infection on the facility expenditures?


Slide 54

Q14. What is the effectiveness of hand hygiene in

preventing health care-associated infection?


Slide 55

Q15. Among all patient safety issues, how important is hand hygiene within your management priorities at your institution?

■ Low priority: (%)■ Moderate priority: (%)■ High priority: (%)■ Very high priority: (%)

Slide 56

Q16. On average, in what percentage of situations requiring hand hygiene do health-care workers in your facility actually perform hand hygiene?

0-10

11-20

21-30

31-4041-50 51-60

61-7071-80 81-90

91-100

0

20

40

60

80

100

%

Percentage of situations where health-care workers perform hand hygiene when required

Slide 57

Q17. Are senior nurses and doctors good examples for the promotion of hand hygiene at your facility?

0

20

40

60

80

100

Not at all 2 3 4 5 6 Very good

%

Slide 58

Q18. Is it common practice to inform patients about the importance of optimal hand hygiene during health-care delivery at your facility?

■ Yes: number (%)■ No: number (%)

Slide 59

Q19. How do you consider the effort required by health-care workers to perform good hand hygiene when caring for patients at your facility?

0

20

40

60

80

100

No effort 2 3 4 5 6 A bigeffort

%

Slide 60

Q20. How do health-care workers perceive your request to perform optimal hand hygiene during patient care at your facility?

0

20

40

60

80

100

Of littleimportance

3 5 Veryimportant

%


Slide 61

Q21. In your opinion, how effective would the following actions be to increase hand hygiene permanently in your facility?

Slide 62

Q21.a. Leaders and senior executive managers (you) at your facility support and openly promote hand hygiene

0

20

40

60

80

100

Noteffective


%

Slide 63

Q21.b. The health-care facility makes alcohol-based handrub available at each point of care

0

20

40

60

80

100

Noteffective


%

Slide 64

Q21.c. Hand hygiene posters are displayed at point of care as reminders

0

20

40

60

80

100

Noteffective


%

Slide 65

Q21.d. Each health-care worker receives education on hand hygiene

0

20

40

60

80

100

Noteffective


%

Slide 66

Q21.e. Clear and simple instructions for hand hygiene are made visible for every health-care worker

0

20

40

60

80

100

Noteffective


%

Slide 67

Q21.f. Health-care workers regularly receive the results of their hand hygiene performance

0

20

40

60

80

100

Noteffective


%

Slide 68

Q21.g. Senior nurses and doctors perform hand hygiene perfectly (being a good example…)

0

20

40

60

80

100

Noteffective


%

Slide 69

Q21.h. Patients are invited to remind health-care

workers to perform hand hygiene

0

20

40

60

80

100

Noteffective


%


Slide 70

Conclusions and recommended actions



Slide 71

Results of the Hand Hygiene Observation Survey

(Name of facility)

Slide 72

Methodology of observation ■ Direct observation of hand hygiene

practices in identified clinical settings

■ One (or two) trained and validated observer(s) observe health-care workers’ hand hygiene practices at the point-of-care

■ Professional categories to be observed: nurse, midwife, auxiliary nurse, medical doctor, therapist, technician, any other health-related professional involved in patient care

■ The observer conducts observations openly, but the identities of the health-care workers are kept confidential

■ Each observation session lasts approx 20 min

■ Compliance against WHO’s “5 Moments for Hand Hygiene” (indications) is detected: before patient contact, before an aseptic task, after body fluid exposure risk, after patient contact and after contact with patient surroundings

■ Compliance is recorded against the opportunities for hand hygiene that occurred

■ Handrubbing with alcohol-based handrub and handwashing practices are also recorded

Slide 73

Methods for data collation and presentation

■ Data entering and analysis using the Data Entry Analysis Tool

■ Calculation of compliance:


Hand hygiene actions performed

Hand hygiene actions required(hand hygiene opportunities)

Compliance =

Slide 74

Observations: Results

■ name of facility■ department

■ x opportunities■ x sessions■ x hours/mins

■ compliance x%

Slide 75

Profession: Number of opportunities

104

67

25

30

Nurse/midwifeMedical doctorAuxiliaryOther

Slide 76

Profession: Compliance

67

4540

35

0

20

40

60

80

100

Nurses/midwife Medical doctor Auxiliary nurses Others

%

Slide 77

Indications: Number of opportunities

15

25

35

15

10

Before touching a patient

Before clean/asepticprocedureAfter body fluids

After touching a patient

After patient surroundings

Slide 78

Indications: Compliance

31

74

57 54

73

0

20

40

60

80

100

Before patient Before asepticprocedure

After body fluid After patient After patientsurroundings

%

Slide 79

Departments: Number of opportunities

213

312

204230

286

254

ObstetricsICULong-termMedicineSurgeryPediatrics

Slide 80

Departments: Compliance

67%

56%

51%

0% 20% 40% 60% 80% 100%

ICU

Medicine

Surgery

Slide 81

Handrubbing vs. handwashing

0%

20%

40%

60%

80%

100%

Surgery Medicine ICU Total

Handwashing

Handrubbing


Slide 82

Conclusions and recommendation actions:



Slide 83

The following 5 slides are examples of how to present results from the evaluation surveys at different moments in time as indicated by the variable Period Number (generated by Epi Info).

This applies to the comparison of baseline and follow-up measurements produced by using the surveys multiple times.

Slide 84

Longitudinal measurement: date range and availability of completed surveys

Period numberDate range Date_1 – Date _2 Number of surveys

X

Y

Z

Total:

Slide 85

Q8-9. – of knowledge survey ("Characteristics of respondents"): comparison of two periods

VariablePeriod X (Date range)

Period Y(Date range)

Period Z(Date range)

Age (median, quartiles)

Gender

Profession (in categories)

Ward

Etc.

Slide 86

Q20. - of the knowledge survey (Percentage of correct answers to question – "Which type of hand hygiene method is required in the following situations?"): comparison of two periods (period X and period Y)

0

20

40

60

80

100

Before palp Before injection After bedpan After gloves After patient'sbed

After blood

Situations requiring hand hygiene

%

Period X Period Y

Slide 87

Q19.a. - of the perception survey ("Leaders and senior managers at your institution support and openly promote hand hygiene"): comparison of two periods

0

20

40

60

80

100

Noteffective


%

Period X Period Y

Slide 88

Indications - Compliance: comparison of two periods (X, date-range 1; Y, date-range 2)

3133

7478

5760

54

7773

63

0

20

40

60

80

100

Before patient Beforeaseptic

procedure

After bodyfluid

After patient After patientsurroundings

%

Period X Period Y


Slide 89

Find out more about why all of these elements are important for improving and sustaining hand hygiene in the WHO Guidelines on Hand Hygiene in Health Care (2009) and in other implementation toolswww.who.int/gpsc

http://www.who.int/gpsc

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