Hand washing practices and techniques among health professionals in a tertiary hospital in Kano

Background: The simple act of hand washing has been proven to reduce the risk of acquiring hospital infection; especially with the current concern of Ebola viral disease. Hospital acquired infections have contributed significantly to overall mortality and morbidity and health care cost. They report that hand washing remains at an unacceptable low level in most medical environments; with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. Transmission of health-care-associated infections often occurs via the contaminated hands of health care workers. Materials and Methods: It was a descriptive cross-sectional study carried out among randomly selected doctors and nurses in Aminu Kano Teaching Hospital; Kano. The questionnaires were administered to the respondents during their ward rounds or clinic sessions. Results: One hundred and forty health professionals comprising 98 nurses and 42 doctors were studied. About 64.4% of them were aware of the World Health Organization (WHO) global hand washing day but only 15% stated the date correctly. About 99.3% of them believed that if hand washing is done correctly it can reduce the risk of infection. All (100%) of the health professionals use water and soap or hand rubs as agents of hand washing. About 93.6% were taught hand washing technique and 47% were aware of the five moments in hand washing but only 17% of them could list the five moments in hand washing. Only 25.7% health professionals knew the correct steps of hand washing (?2 = 2.444; df = 2; P = 0.295). Ninety-one percent of the health professionals had seen posters on hand washing. Majority (72.1%) adhered to principles of hand washing (?2 = 0.015; df = 1; P = 0.902) while 82.1% wash their hands before touching patients (?2 = 2.841; df = 1; P = 0.092). However; most of them (95%) washed their hands after touching patients and 97% washed their hands after handling body fluids or secretions from patients. On the other hand; only 39% health professionals washed hands before wearing hand gloves (?2 = 0.321; df = 1; P = 0.571) but 95% washed hands after removing the hand gloves. Ninety-nine percent washed their hands after visiting or using the restroom. Conclusion: This study underscores the need for continuous information and education of health professionals on the importance WHO global hand washing day. As doctors and nurses are important in the health care team; it is important to provide the appropriate knowledge and training regarding preventive practices of infectious diseases. Training and retraining of health professionals on correct steps of hand washing will encourage and remind them on the importance of washing hands before wearing gloves and before touching patients to reduce the risk of infection and cross infection

Hand Hygiene Practices in a Neonatal Intensive Care Unit in Ghana

Background: Compliance with hand hygiene recommendations is the most important measure in preventing health care-associated infections. The objective of this study was to assess the nature of patient contact and the hand hygiene practices of nurses and physicians in the neonatal intensive care unit in a tertiary hospital in Ghana. Methodology: Unobtrusive observation of patient contact; hand hygiene practices; and hand washing technique among nurses and physicians attending randomly selected newborns for five hours daily for two weeks. Patient contact categorized as low-risk or high-risk. Hand hygiene practice before and after patient contact categorized as clean uncontaminated; clean recontaminated; new gloves; unchanged gloves. Compliance to alcohol rub use assessed. Results: The patient to nurse/physician ratio varied from 9:1 to 12:1. There were 97 patient contacts of which 49 were high-risk and 48 low-risk. Most (73) patient contacts were from nurses. Compliance to hand hygiene recommendations before versus after patient contact was 15.4versus 38.5for physicians and 14.1versus 9.9for nurses. Gloves were used for 60.8patient contacts (85.7high-risk; 35.4low-risk); however; compliance to recommended procedure occurred in only 12.2of high-risk contacts and none of the low-risk contacts. Gloves were not changed between patients in 43.7of high-risk contacts and 88.2of low-risk contacts. Hand washing protocol was generally followed. Alcohol hand rub was always available but was not used for hand hygiene. Conclusions: Hand hygiene compliance of physicians and nurses was low. Gloves and alcohol rub were not used according to recommended guidelines. Incorporating effective education programs that improve adherence to hand hygiene guidelines into the continuing education curriculum of health professionals is recommended

Survey of knowledge, attitudes, and practices regarding tuberculosis among general and private medical practitioners in Nigeria

The knowledge and practice regarding tuberculosis (TB) treatment was surveyed by analysing questionnaires distributed to 390 general and private medical practitioners in Nigeria. Of the 350 (89) questionnaires returned; 305 (87.1) practitioners had treated TB cases in their hospitals. The number of regimens recorded were 85 for newly diagnosed (ND) cases and for 45 re-treatment (RT) cases. The National Tuberculosis Control Programme (NTCP)-approved regimen were used in 61 (20) ND cases and 60 (19.7) RT cases. The number of inadequate regimens prescribed were 60 (70.6) for ND cases and 36 (80) for RT cases; 34 (40) practitioners wrongly stated that strepto- mycin should be used for ND cases. In ND cases; regimens lasting less than 6 months were prescribed in 8 (9.4) cases; and regiments lasting more than 12 months were prescribed in 10 cases (11.7). Other aspects of poor knowledge were exhibited by a significant number of respondents who estimated seeing an average of 1525 TB patients each month. It was concluded that a significant number of physicians in private practice did not adhere to the standard norms for prescribing anti-TB treatment; did not know about the regimen recommended by the NTCP; and often prescribed wrong regimens. Intervention strategies in the form of continuing medical education in TB should be urgently organised for general and private medical practitioners if the disease is to be controlled in Nigeria