Increase Awareness about Hand Hygiene Compliance between Health Staff Workers in Health Center in Qatar

By

ACKNOWLEDGEMENT

I am most thankful to my family colleagues and instructor for providing me assistance and guidance throughout the tenure of this research project. This research would not have been completed without their undue support.

DECLARATION

I declare that this study has not been published previously and represents my own work based on the secondary and the primary research analysis.

ABSTRACT

This intervention project aimed to increase awareness of hand hygiene among the professionals of the healthcare centers of Qatar. During the first phase, observation of hand washing behavior were collected from the doctors and the nurses of the selected outpatient centers, which were later on facilitated by the focus group study. The interventions were divided into three steps namely the baseline evaluation, 3 weeks during the intervention and 3 weeks post intervention. A significant increase was found in hand wash compliance that is from 45% (baseline evaluation) to 78% (3 weeks during the intervention) and finally to up to 84% (3 weeks post intervention). This shows that the behavior of the healthcare professionals can be rectified using the behavior based intervention as depicted by this intervention study.

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

LIST OF FIGURESVII

CHAPTER 1: INTRODUCTION1

Background1

Nature of the Change2

Rationale for Selecting the Change2

Rationale for Carrying Out the Project3

Context of the Change3

Scope and Expected Outcome5

Potential Threats to Implementing the Change5

Method and Evaluation of the Change6

CHAPTER 2: LITERATURE REVIEW7

Theoretical Review8

Hand Hygiene Theory8

The Theory of Reasoned Action9

The Theory of Planned Behavior10

Hand hygiene in Different Religions12

Worldwide Hand Hygiene Practices14

Hand hygiene and Risk of Healthcare Associated Infections15

The Incidence Rate of Infections17

What is the Treatment-Related Infection?17

Why Healthcare-Associated Infections should be prevented?19

Why Healthcare-Associated Infections are monitored?20

Importance of Good Hand Hygiene20

Hand Hygiene Procedures21

The Importance of Hand Hygiene in the Prevention of Healthcare-Associated Infections21

Challenges and Difficulties of Implementing Hand Hygiene Practice22

WHO 5 Moments for Hand Hygiene25

Before contact with the patient26

Before aseptic task26

After the risk of exposure to body fluids26

After contact with the patient26

After contact with patient surroundings27

CHAPTER 3: METHODS29

Introduction29

Issues Related to Resistance and Power30

Change Model31

Justification for Using Kotter's Model31

Steps of Implementing the Model32

Implementing the Strategy36

Change in the System and Facility Preparation36

CHAPTER 4: EVALUATION38

Introduction38

Indicators to Determine the Project Outcomes38

The Evaluation Process39

Evaluation Tools39

Methodology39

Data Analysis39

Focus Group40

Baseline Evaluation41

Audit for Measuring Compliance42

Ethical Considerations42

Comments on the Validity Techniques43

Change Outcome45

Compliance of Hand hygiene by Healthcare facility46

Compliance of Hand hygiene by the profession47

Indication of Hand Hygiene49

Summary49

CHAPTER 5: DISCUSSION AND CONCLUSION50

Impact on the Organization50

Strengths and Limitations of the Project50

Recommendations for Future Research51

Implication for Practice51

Conclusion52

REFERENCES54

A: Different types of hand hygiene68

B: How to Hand Wash69

C: How to hand rub70

List of Figures

Fig 1: Source: Health facilities/services, Qatar4

Fig 2: The data from GCC Countries15

Fig 3: Factors Discouraging hand hygiene Compliance25

Fig 4: WHO 5 Moments for Hand Hygiene Source: World Health Organization (2009).27

Fig 5: Indicators to Determine the Project Outcomes38

Fig 6: Compliance Change Outcome45

Fig Appendix A: Different types of hand hygiene B: How to Hand Wash69

Fig Appendix B: How to hand washC: How to hand rub70

Fig Appendix C: How to hand Rub71

CHAPTER 1: INTRODUCTION

Background

The Hand hygiene is a general term that applies to any hand washing, antiseptic ...