Hand hygiene competence in the intensive care unit

The hand hygiene knowledge and competence of staff in an adult Intensive Care Unit (ICU) was measured at a 450 bed Australian metropolitan teaching hospital. Staff working in or entering the ICU to perform patient care over a two-month period were asked to complete a questionnaire that examined their knowledge on current hand hygiene policy and procedures. Hand hygiene practice was also assessed by observation. Sixty-six staff participated including 50 registered nurses (RNs), eight medical staff (MOs), five surgical dressers (SDs) and three radiographers (XRay technicians). Radiographers were excluded from the statistical analysis due to low numbers participating. Scores on the knowledge component of the questionnaire ranged from 5-10/10 (mean 7.39 ± 1.04 std. dev). Scores on the practical component ranged from 3-6/6 (mean 5.83 ± 0.56). Mean knowledge scores by profession were: 7.75 (MOs), 7.38 (RNs), and 6.60 (SDs). Mean competence scores by profession were: 5.75 (MOs), 5.88 (RNs), and 5.80 (SDs). There were no significant differences in hand hygiene knowledge (p= 0.178) and hand hygiene competence between professions (p=0.780). The greatest knowledge deficit lay in what constituted a routine handwash and in which situations routine handwashing was required. Introduction The goal of competency assessment is to evaluate the performance of an individual or group in order to determine if they are able to effectively apply knowledge and skills in the clinical setting to ensure the best patient care. Competency testing can also provide feedback to educators on knowledge deficits that need to be addressed, or on the efficacy of current educational programs, and at the same time highlight for the staff themselves areas in which their knowledge and skills need updating. Additionally, competency testing offers a way of encouraging staff to be accountable for their practice. 3 As hand hygiene is a vital component of any infection control program, it is important to know what health care workers know about hand hygiene policies and procedures, and how competent they are at applying their knowledge. While many studies have been conducted on hand hygiene compliance and hand hygiene behaviour, a search of the terms competence, competency, handwashing and hand hygiene on the databases CINAHL and MEDLINE revealed no literature on the topic of hand hygiene competence. Thus the aim of this study was to examine hand hygiene knowledge and competence amongst a group of health care workers in the Intensive Care environment in order to determine if there were deficits in hand hygiene knowledge or practice. The research questions were: 1. What do health care workers know about current hand hygiene policy and procedures? 2. Is there a relationship between hand hygiene knowledge and hand hygiene competence? 3. Does profession influence hand hygiene knowledge or hand hygiene competence?