Researchers at Hannover Medical School have taken a closer look at hand hygiene in the operating room—with interesting results.
Careful hand disinfection in the operating room is an important part of infection prevention and patient safety. The consequences of poor hand hygiene are well documented. Postoperative wound infections are one of the most common types of healthcare-acquired infections (HAIs). In Germany alone, they cause up to one million additional hospital stays per year [1].
This makes the findings brought to light by a team of researchers from the Hannover Medical School (MHH) disheartening. As part of a study, the scientists investigated hand hygiene compliance in a university hospital operating room over a period of two months [2]. Of the total 1145 observed opportunities for hand disinfection, only 467 were ultimately performed. This translates into a hand hygiene compliance rating in the operating room area of just over 40 percent.
Hand hygiene compliance gaps
Interestingly, disinfection behavior differs role by role within the hospital staff. In the study, for example, anesthesiologists followed the rules for hand hygiene in the operating room more frequently than surgeons. The MHH researchers determined a hand hygiene compliance of 46.1 percent for the anesthesiologists. For the surgeons, the value was just under 30 percent, representing a statistically significant difference.
To calculate disinfection behavior, a doctoral student observed staff in the OR based on the 5 Moments of Hand Hygiene, launched by the World Health Organization (WHO) in 2009 and adapted from numerous national guidelines.
The research team led by Dr. Claas Baier and Maren Tinne also compared whether there were any differences between nurses and physicians in terms of hand disinfection behavior. They found that the nurses on the OR ward came off better than the physicians in terms of hand hygiene compliance (42.9% vs. 38.5%).
Disinfectant dispensers in the OR
The ward relied on permanently installed Euro-dispensers in the induction rooms, operating rooms, and other locations in close proximity to patients. The study authors said that sanitizer dispensers were not used in the mobile operating tables area.
In their conclusion, the researchers make clear that “sustained interventions are urgently needed to improve hand disinfection” and emphasize the importance of continuous measurement of hand hygiene compliance. This is where solutions such as the OPHARDT Hygiene Monitoring System® (OHMS) (new name Kanary) come in, which is already being used in numerous German and European hospitals. By the end of 2021, OHMS broke the mark of 50 million measured hand disinfections. By tracking ward-based hand hygiene compliance automatically, hospitals can know exactly where and when to intervene.
Sources for the article “Hand Hygiene in the operating room”:
[1] Gastmeier, P., et al. “Postoperative wound infections after inpatient and outpatient surgery.” Bundesgesundheitsblatt-Health Research-Health Protection 47.4 (2004): 339-344.
[2] Baier, Claas, et al. “Compliance with hand disinfection in the surgical area of an orthopedic university clinic: results of an observational study.” Antimicrobial Resistance & Infection Control 11.1 (2022): 1-7.
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