India Infection Control: Hand Hygiene Training for Behavioural Change Among Nurses in a Dehli Based Hospital

Studies have shown that hospital acquired infections (nosocomial infections) are considered among the leading causes of death in hospitals. The program objective was to reduce the incidence of hospital acquired infections by improving hand hygiene attitudes and practices among nurses working at a private hospital in Delhi.

A situational analysis was conducted on 256 nurses working on ICU and general wards to document availability of resources needed to prevent nosocomial infection and record baseline values of urinary infections, surgical site infections, blood stream infections, and ventilator associated pneumonia (VAP). This included interviews with a sample of 20 nurses selected by block randomization working in ICU and general wards.

Post training the nurses' knowledge of hand washing after removing gloves increased substantially from 5% to 95%. Awareness of hand wash after aseptic and cleaning procedures increased from 40% to 66%. There was also a prominent decline in VAP infection rates among patients from 21.7/1000 ventilator days in June 2010 to 11.4/1000 ventilator days in September 2010. Direct observations of nurses post training shows 77% compliance with standard hand hygiene practices per WHO guidelines for proper hand washing techniques, use of hand rubs and gloves. Prior to program start, the compliance rate was approximately 45%.

The program illustrates that a structured training on standard hand hygiene practices for the workforce in a hospital can increase knowledge and enhances attitudes towards best practices in favour of quality of healthcare delivery.