OPHARDT hygiene
Hand disinfection in hospitals: a European comparison
Research

Hand disinfection in hospitals: a European comparison

Survey shows differences in the equipment with disinfectant dispensers and in the consumption of hand disinfectants in European hospitals.

What influence do structural features in hospitals have on hand hygiene? This question was addressed in the Europe-wide PROHIBIT (Prevention of Hospital Infections by Intervention and Training) study. After all, hospitals do not always have the same equipment and infrastructure. One of the reasons for this is that each country has defined its own guidelines for hospital hygiene. Individual national initiatives to improve hand hygiene also have an impact on the setting of a hospital. This applies, among other things, to the available number of disinfectant dispensers.

Hand hygiene for infection protection.

However, everyone agrees on one point: careful hand disinfection plays the same prominent role in preventing nosocomial infections in every European hospital, and the World Health Organization (WHO) also attributes hand hygiene the “most important infection prevention measure”.

How well this measure is implemented in everyday clinical practice depends on the availability of hand disinfectants. Especially the attachment of dispensing systems at the so-called “point-of-care” – i.e. in the immediate vicinity of the patient, is of decisive importance as to how effective or less effective compliance is in medical facilities for hand hygiene.

Northern and Western Europe ahead in dispenser equipment.

The PROHIBIT study examined the performance of individual European countries in terms of dispenser equipment on the basis of questionnaires completed by a total of 309 hospitals. The result: The intensive care units in northern and western Europe have the highest values for the equipment of disinfectant dispensers at the point-of-care. The participating hospitals from Sweden, Finland and Switzerland, for example, are at the top of the rankings with almost optimal equipment. In the intensive care units in Slovakia, only 40% of intensive care units reported adequate availability of hand disinfectants in the direct vicinity of patients.

The better the equipment, the higher the consumption.

A further focus of the scientists was the question of whether the availability of disinfectants also ensures higher consumption at the same time. The results confirm that the better the availability, the higher the hand disinfectant consumption per patient day in the examined intensive care units. Ultimately, it could be argued that compliance with a good level of equipment also increases, as researchers found a correlation between consumption and compliance in 2016.

This means that hospitals in the north and west of Europe are also at the top in this area – as can be seen in various types of wards. For example, the median of hand disinfectant consumption per patient day in an intensive care unit in Austria is 98 ml. Comparable wards in Poland have a corresponding value of 67 ml.

Based on an average removal quantity of 3 ml per hand disinfection, just over twenty hygiene events per patient are carried out here.

Robust holding solutions for the point of care.

It has been shown that permanently installed hygiene dispensers in the direct patient environment offer sustainable added value within the framework of infection protection. Holding solutions for attaching disinfectant dispensers to the patient’s bed or wall-mounted dispensers within the patient’s room, which fit seamlessly into the workflow of the hospital staff, appear to be sensible.

Source: Hansen, Sonja, et al. „Provision and consumption of alcohol-based hand rubs in European hospitals.“ Clinical Microbiology and Infection 21.12 (2015): 1047-1051.

*Haubitz, Sebastian, et al. “Handrub consumption mirrors hand hygiene compliance.” infection control & hospital epidemiology37.6 (2016): 707-710.

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