Barreras y facilitadores para el uso de preparados de base alcohólica: elemento clave de la estrategia multimodal para aumentar la adherencia a la higiene de manos: revisión sistemática cualitativa / Barriers and motivating factors in the use of alcohol based products: the key to a multimodal strategy to increase compliance with hand hygiene practices: cualitative systematic review

INTRODUCCIÓN: La adherencia a la higiene de manos (HM) por parte del personal de salud es de 38% a nivel mundial. Con la estrategia multimodal de la OMS se incluyeron los preparados de base alcohólica como un componente para la mejora de la HM. La campaña "los 5 momentos de la HM" incentiva a utilizar este producto que, entre otros beneficios, su aplicación ocupa menor tiempo en comparación con el lavado de manos. OBJETIVO: Conocer cuáles son los factores facilitadores o las barreras que favorecen o dificultan el uso de preparados de base alcohólica por el personal de salud para aumentar la adherencia a la HM según la estrategia multimodal de la OMS. MÉTODOS: Fueron utilizadas dos bases de datos PubMed y CINHAL (años 2009 - 2019). Los artículos fueron seleccionados según criterios de inclusión - exclusión. RESULTADOS: De 30 artículos se seleccionaron 12, los que tenían como tema central la adherencia a la HM, personal de salud y preparados de base alcohólica. Se organizaron en facilitadores y barreras: infraestructura, presentación del producto y capacitación del personal. DISCUSIÓN: Los facilitadores y barreras que más impacto reportan en aumentar la adherencia a la HM son la infraestructura, acceso, disponibilidad en el punto de atención, presentación del producto y capacitación al personal de salud sobre los productos de base alcohólica para la desinfección de las manos, con el fin de disminuir las IAAS y brindar una atención segura.

INTRODUCTION: The compliance with HH (hand hygiene) practices by health personnel is 38.7% worldwide. Using a multimodal strategy of the WHO (World Health Organization), alcohol based products was introduced. The campaign "The five moments of HH" encourages the use of this product which offers countless benefits, an important one being that it takes much less time compared to hand washing. OBJECTIVE: To discover what the motivating factors or barriers are that favor or hinder the use of alcohol based products by health personnel, in order to increase compliance with HH according to the WHO multimodal strategy. METHODS: Two databases were used; PubMed and CINHAL (from 2009 - 2019) The articles were selected according to inclusion - exclusion criteria. RESULTS: From 30 articles, 12 were selected that had HH compliance, health personnel and alcohol based products as their main topics. They were organized into motivating factors and barriers: using infrastructure, product presentation and staff training. DISCUSSION: Discovering the motivating factors and the barriers is essential to directing the efforts of strategies that include these points and to increase the compliance of HH with health personnel in order to reduce the HCAI (Health Care Associated Infection) and provide safe healthcare.

Proper hand washing practice among mothers and occurrence of diarrhoea among family members.

A cross-sectional analytic study was done to determine the self-reported prevalence of proper hand washing practice among mothers and its relationship with the occurrence of diarrhoea among family members in Mandalay during 2011. Altogether 829 mothers (one from each household) from Chan-Aye-Tharzan and Mahar-Aung-Myay townships were selected by using systematic random sampling procedure. Face to face interview method was used to collect the necessary data. The prevalence of proper hand washing practice as reported among mothers was almost 80% (95% CI = 76.6%, 82.1%) but the occurrence of diarrhoea reported among her family members including herself within past one year was 18.2% (95% CI = 15.7%, 20.9%). Family income (p = 0.006) and education status (p = 0.048) were found to have significant effects on reported practices of proper hand washing. Moreover, proper hand washing practice by mothers was found to have significant effect on the occurrence of diarrhoea among all family members including herself (p < 0.001). It was apparent that if the mother washed her hands properly, the annual occurrence of diarrhoea would be reduced among the whole family (48% of current occurrence), among other family members (53%) and herself (50%). Although proper hand washing practice among mothers is satisfactory, habit of this hygienic behavior should be promoted in the whole country to prevent episodes of diarrhoea especially giving priority to low income households and mothers with low education status.