1. Hand Washing Khalil khalidy Mohammed El-Kurdi Hamza Habib Abdullkareem Alssalqawy Date

2. Background to the audit  Why was the topic selected? 1.Thousands of people die every day around the world from infections acquired while receiving health care. 2.Hands are the main pathways of germ transmission during health care. 3.Hand hygiene is therefore the most important measure to avoid the transmission of harmful germs and prevent health care-associated infections. 4.This presentation explains how and when to practice hand hygiene.

3. Aim of the audit  To evaluate the commitment of health care worker in Al Emirati hospital to the WHO guideline of hand hygiene

4. Objectives of the audit  To determine : 1- compliance rate in different groups of health care workers. 2- health care worker behavior. 3- the most used detergent objects. 4- wither the hand washing is done properly or not.

5. Identifying Best Practice  Best practice was identified according to the WHO’s patient safety guidelines regarding hand hygiene of all health care workers within clinical institution environment, as well as : -the Hand Hygiene Self-Assessment Framework of 2010. -the local hospital’s procedures that were clearly stated by the instructional posters spread across the wards and clinic.

6. Criteria and standards  Criteria regarding Hand Hygiene assessment.  Criteria regarding the ability of the institution to provide an optimal facilitations for hand hygiene.

7. Criteria and standards  Criteria regarding Hand Hygiene assessment.  Criteria regarding the ability of the institution to provide an optimal facilitations for hand hygiene.

8. 1.System Change 2.Training and Education 3.Evaluation and Feedback 4.Reminders in the Workplace 5.Institutional Safety Climate for Hand Hygiene

12. Population and sample  The population consists of the whole medical and healthcare staff within the wards, delivery room and the ER.  That sample was picked randomly that consisted of an average of 15 observations daily.

13. Data collection  The data were collected manually using a check list sheet.  The data collection started on 13 h of Dec 2015 till …………..  It was collected by 4 of IUG’s 5 th year medical students with the assistance of Dr. Abdel Karim (board doctor?! ) under the super vision of Dr. Bettina Botcher  show the audience the data collection tool used (handout)

14. Data analysis  How was the clinical audit data analyzed? (SPSS\by hand (tally chart))  When was the data analysed (times/dates/years) and approximately how long did it take to analyse the data?1  Who analysed the clinical audit data? 5 th year medical students !

15. Audit results The study covered 52 observations 45 doctor 4 nurses (must collect more information ?) 3 Med std

16. Audit results ( general ) Location hcw loctionN% of Total N ward2548.1% ER35.8% DR1936.5% OPC59.6% Total52100.0%

17. Audit results ( general ) Wash hcw WashN% of Total N No2955.8% Yes2344.2% Total52100.0%

18. Audit results ( general )

19. Moments hcw MomentN% of Total N 41878.3% 3.4313.0% 1.2.314.3% 1.2.3.414.3% Total23100.0%

20. Audit results ( general )

21. Technique Score FrequencyPercent Valid 1626.1 21460.9 328.7 614.3 Tot al 23100.0

22. Audit results ( general )

23. Audit results ( general ) like this diagram

24. Audit results ( general ) Action FrequencyPercent Valid water1460.9 Hey Gel14.3 water and soap 834.8 Total23100.0

25. Audit results ( general )

26. Drying FrequencyPercent Valid none1669.6 diaposable tissue 730.4 Total23100.0

27. Audit results ( general )

28. Sanitarily FrequencyPercent Valid no1669.6 yes730.4 Total23100.0

29. Audit results ( general )

30. Gloves (ALL) FrequencyPercent Valid off2038.5 on3261.5 Total52100.0

31. Audit results ( general )

32. Gloves for whom didn’t wash FrequencyPercent Valid off724.1 on2275.9 Total29100.0

33. Audit results ( general )

34. Gloves for whom washed FrequencyPercent Valid off1356.5 on1043.5 Total23100.0

35. Audit results ( general )

36. Audit results ( Doctors) WashN% of Total N No2862.2% Yes1737.8% Total45100.0%

37. Audit results ( Doctors) MomentN% of Total N 41376.5% 3.4317.6% 1.2.315.9% Total17100.0%

38. Audit results ( Doctors) techniqueN% of Total N 1317.6% 21376.5% 315.9% Total17100.0%

39. Audit results ( Doctors)

41. Audit results ( Nurses) WashN% of Total N No125.0% Yes375.0% Total4100.0%

42. Audit results ( Nurses) MomentN% of Total N 43100.0% Total3100.0% MomentN% of Total N

43. Audit results ( Nurses) techniqueN% of Total N 13100.0% Total3100.0% techniqueN% of Total N

44. Audit results ( Nurses) techniqueN% of Total N 13100.0% Total3100.0% techniqueN% of Total N

45. Audit results ( Nurses)

46. Audit results ( Students) WashN% of Total N Yes3100.0% Total3100.0%

47. Audit results ( Students) MomentN% of Total N 4266.7% 1.2.3.4133.3% Total3100.0%

48. Audit results ( Students) techniqueN% of Total N 2133.3% 31 61

49. Audit results ( Students)

51. Observations  The hand washing percentage is 44.2 % of all observations.  in which : - 78.3% were done at the moment 4. - 4.3% of standard technique. - 60.9% used water only. - Only 34% used soap. - 69.6 % didn’t use drying objects, with 45 % using their clothing. - only 30.4 % kept their sanitarity properly.

52. Observations  The hand washing percentage is 44.2 % of all observations.  in which : - 78.3% were done at the moment 4. - 4.3% of standard technique. - 60.9% used water only. - Only 34% used soap. - 69.6 % didn’t use drying objects, with 45 % using their clothing. - only 30.4 % kept their sanitarity properly.

53. Observations  75.9% of whom did not wash their hands wore disposable Gloves.  None of the workers covered washing : Nails and between fingers.  Regarding doctors the highest technique score was 3\6 with a percentage of 5.9%  Should I add more observations? Or leave room of discussion.

54. Discussion  Whats the cause behind this results ?  Is it : -Lack of facilities. -Lack of education. -Carelessness of the workers. - would be verbally said to allow interaction and avoid boredom.

55. Factors affecting compliance to hand hygiene

56. The following will be decided after we complete the data collection so we cold apply he framework score to the proper WHO plan

57. Recommendations and actions

58. Next steps

59. Acknowledgements  A list should be provided of all those who helped to conduct the clinical audit project, for example: -- Clinical audit facilitator (Dr. Bettina Bottcher) - Local hospital Trust (for sharing their audit report)

60. References