High nursing workload is a main associated factor of poor hand hygiene adherence in Beijing, China: An observational study.

Aim: The aim of the study was to explore the impact of nurse workloads on adherence to hand hygiene. Background: Adherence to hand hygiene and nursing workloads have been linked to quality of patient care. Therefore, it was important to understand the relationship to safe patient care. Design This cross‐sectional study was performed from January 2016 to June 2016. Methods: Workloads and adherence to hand hygiene for nurses on 3‐day shifts in a tertiary hospital were investigated in 2016. Actual hours worked per shift were timed using a stopwatch to assess nursing workloads. Descriptive and inferential statistics and multiple variable regression analysis were used to analyse the data. Results: Sixty‐four nurses from four wards were observed. The average adherence rate of hand hygiene was 26.6% and the average nursing workload per shift was 6.7 hours. Multiple regression revealed that nursing workload was negatively related to adherence rate of hand hygiene. Conclusion: Nurses in this study that had a low rate of adherence with hand hygiene frequently had high workloads. Adherence to hand hygiene was independently associated with actual hours worked per shift. SUMMARY STATEMENT: What is already known about this topic? Adherence to proper hand hygiene by nurses is one of the most effective and efficient ways to prevent the spread of hospital‐acquired infections and the dissemination of multi‐antimicrobial resistance.Adherence to hand hygiene among clinical nurses has been continually substandard and nurses' high workload is their most common self‐reported reason for nonadherence.High workloads are a common problem worldwide because of the shortage of nurses. What this paper adds? Nurses on surgical wards worked long hours.Adherence to hand hygiene was negatively related with nursing workloads.Nurses prefer hand washing to alcohol‐based hand rub for hand hygiene. The implications of this paper: In the general ward, high workloads pose barriers to adherence to hand hygiene, and any improvement efforts should be considered in this context.In general, increased numbers of patients are to be cared for lead to more opportunities for hand hygiene, but this heavy workload contributes to a lack of adequate time to perform proper hand hygiene, with a resulting decrease in adherence to hand hygiene.This study highlights the need for improvement programmes focusing on the quality and adherence rates for proper hand hygiene.Measuring adherence rates with hand hygiene and nursing workloads are helpful for both proper allocation of nursing resources and enhancement of patient safety. [ABSTRACT FROM AUTHOR]