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10-Jun-2025
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Arch Hellen Med, 42(4), July-August 2025, 540-547 ORIGINAL PAPER Compliance of health professionals with the "5 moments" of hand hygiene D. Constantinou,1 I. Leontiou,2 M. Mpouzika,3 K. Michail,3 N. Middleton,3 A. Merkouris3 |
OBJECTIVE To investigate the compliance of health care professionals with implementing hand hygiene in four departments of two clinics of a major general hospital of Cyprus according to the clinical guidelines proposed by the World Health Organization (WHO).
METHOD The study was conducted between November and December 2019. To measure the compliance rate of healthcare professionals in the "5 moments" of hand hygiene the direct observation method was applied, as described in the WHO guidelines. The study sample consisted of 177 health professionals, working in four departments, two medical and two surgical departments. Observation sessions were conducted only during the morning and afternoon shifts because more interventional procedures take place during that time. A total of 643 opportunities were recorded and the duration of each observation was 20±10 minutes.
RESULTS The rate of overall hand hygiene compliance was 36.5%. The highest rate of compliance was with step 3: "After exposure to the patient's biological fluids − 61.1%", while the lowest was with steps 2: "Before any clean or sterile handling − 5.8%" and 1: "Before patient contact – 16.1%" (p<0.001). Regarding the preferred hand hygiene technique, doctors used alcohol solution more often (33.1%), while nurses and ward assistants used gloves much more often (44.0% and 54.0%, respectively) (p<0.001). The professional category of physiotherapists had the highest compliance rate (52.4%) compared to doctors (52.4%), nurses (35.5%) and ward assistants (29.2%). The compliance rate between the surgical departments showed a significant difference (46.0% vs 27.5%, p=0.022).
CONCLUSIONS The present study demonstrated a very low rate of compliance with the WHO guidelines for hand hygiene among healthcare professionals, in a quaternary hospital of Cyprus. Considering that monitoring compliance with the "5 moments" of hand hygiene is considered an indicator of the quality of health services, its implementation is essential. At the same time, it is necessary to implement a comprehensive programme and strengthen appropriate interventions to improve the understanding of the factors that influence hand hygiene compliance.
Key words: Five moments of hand hygiene compliance, Hand hygiene, Observation, Surveillance.
