Search

Introduction: Infection is the most common cause of hospitalisation and the second most common cause of mortality amongst haemodialysis (HD) patients, after cardiovascular disease. Hand hygiene (HH) reduces infections and enhances patient safety across all settings. However, the lack of compliance with HH amongst health-care providers is problematic worldwide. With the above background, a study was conceptualised to ascertain the current status of the HH practices during a complete HD procedure among nursing staff of an HD unit at a tertiary healthcare teaching institute in India. Methodology: A prospective cross-sectional study was conducted from 10 October, 2018, to 10 December, 2018. A structured checklist for HH during a complete HD procedure was developed as per the WHO's five moments of HH. One hundred and fifty HD procedures were observed for compliance appropriate number of HH. Data analysis was done using the SPSS version 22. Results: Despite being a very simple step, the compliance rates of health-care workers (HCWs) in HH were found extremely poor, ranging from 23% to 35% only. Reasons for non-compliance by HCWs told by them were: poor nurse-to-patient ratio, frequent turnover of nursing staff, lack or inadequate training and lower level of competency among HD staff. Conclusion: The high number of times an HD staff is required to perform HH could be a reason for lack of compliance. However, compliance can be improved by continuous education and supervision and by providing, in convenient locations, sufficient number of sink with soap dispensers, paper towels, hand lotions and Anti-Bacterial Hand Rubs (ABHRs) placed at each patient station. [ABSTRACT FROM AUTHOR]

BACKGROUND: Blood transfusion chain can be divided into three phases: preanalytical (patient bedside), analytical (steps done at transfusion services), and postanalytical (bedside). Majority (~70%) of events due to blood transfusion have been attributed to errors in bedside blood administration practices. Survey of bedside transfusion practices (pre-analytical and post analytical phase) was done to assess awareness and compliance to guidelines regarding requisition and administration of blood components. MATERIALS AND METHODS: Interview-based questionnaire of ward staff and observational survey of actual transfusion of blood components in total 26 wards of the institute was carried out during November-December 2013. All the collected data were coded (to maintain confidentiality) and analyzed using SPSS (v 20). For analysis, wards were divided into three categories: medical, surgical, and others (including all intensive care units). RESULTS: A total of 104 (33 resident doctors and 71 nursing) staff members were interviewed and observational survey could be conducted in 25 wards during the study period. In the preanalytical phase, major issues were as follows: lack of awareness for institute guidelines (80.6% not aware), improper sampling practices (67.3%), and prescription related (56.7%). In the postanalytical phase, major issues were found to be lack of consent for blood transfusion (72%), improper warming of blood component (~80%), and problems in storage and discarding of blood units. CONCLUSION: There is need to create awareness about policies and guidelines of bed side transfusion among the ward staff. Regular audits are necessary for compliance to guidelines among clinical staff. [ABSTRACT FROM AUTHOR]