Abstract:
Experts agree that a lege artis conducted hygienic hand disinfection is the most important measure to reduce nosocomial infections (e.g. with multidrug-resistant pathogens such as MRSA).
In practice however, there is a lack of compliance with the relevant requirements (e.g. the guidelines of the Robert Koch Institute).
This work examines the influence of an education of the staff on the risks of non-compliance and the proper use of hand sanitizer to its consumption in a surgical operating area.
In parallel, target values got determined by observing operations of 12 different disciplines in terms of indications for hand disinfection. These target values are getting used to calculate the compliance.
The study shows an initial temporary rise - probably triggered by the Hawthorne effect, but even after the education session the disinfection behavior improved only temporarily.
The results of the clinical trial are explained mainly by the lack of a sustainable change of behavior and resistance at their induction.
Finally, to improve the situation, a strategy is getting developed out of a combination of several measures that have been proven in other studies already. Especially a change in the system, regular training, motivation and support through all levels of hierarchy (top-down management) got identified as key success factors.