CC BY-NC-ND 4.0 · Journal of Child Science 2017; 07(01): e27-e31
DOI: 10.1055/s-0037-1604263
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Comparison of Hand Hygiene Attitudes and Hand Swab Cultures in the Mothers of Children with Heart Disease Before and After Cardiac Surgery

Aysu Türkmen Karaağaç
1   Department of Pediatrics, Kartal Koşuyolu Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
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29. April 2017

07. Juni 2017

19. Juli 2017 (online)


Nosocomial infections (NI) carry high risk of morbidity and mortality especially for children undergoing surgeries. Hand hygiene (HH) is the most effective and economic measure of NI control. This study was designed to compare the HH practices (HHPs), maternal anxiety scores (MASs), and hand swab cultures (HSCs) in the mothers of children with heart disease before and after cardiovascular surgery (CVS) to determine the factors that raised maternal HH sensitivity for prevention of NI. This prospective study included 120 mothers (age: 20–45 years; mean: 31.6 ± 5.6 years), whose children underwent CVS in the Kartal Koşuyolu Research and Training Hospital, University of Health Sciences between November 2016 and February 2017. HHP of each mother was assessed by a questionnaire, 10 questions in two parts and HH score (HHS) was acquired. Then, HSC was obtained. Beck anxiety inventory was applied to determine MAS. The relations among demographic characteristics, MAS, HSC results, and pre-/postoperative HHS of the mothers were compared statistically. There was a significant increase in the HHS of the mothers in the postoperative period. Cronbach's a coefficient of the questionnaire was 0.84. Maternal HHS was significantly correlated with maternal age (p = 0.001), education (p = 0.002), and MAS (p = 0.001), but not with the income (p = 0.2). Moreover, one mother in the postoperative period (0.8%) versus five mothers in the preoperative (4.2%) had positive HSC. High education level, advanced age, and severe anxiety experienced by the mothers in their children's perioperative period were found to be the main factors that have raised maternal HHS, thereby resulting in better HSC results.

  • References

  • 1 Grisaru-Soen G, Paret G, Yahav D, Boyko V, Lerner-Geva L. Nosocomial infections in pediatric cardiovascular surgery patients: a 4-year survey. Pediatr Crit Care Med 2009; 10 (02) 202-206
  • 2 Dixit D, Hagtvedt R, Reay T, Ballermann M, Forgie S. Attitudes and beliefs about hand hygiene among paediatric residents: a qualitative study. BMJ Open 2012; 2 (06) e002188
  • 3 Martínez JA, Pozo L, Almela M. , et al. Microbial and clinical determinants of time-to-positivity in patients with bacteraemia. Clin Microbiol Infect 2007; 13 (07) 709-716
  • 4 Stover BH, Shulman ST, Bratcher DF, Brady MT, Levine GL, Jarvis WR. ; Pediatric Prevention Network. Nosocomial infection rates in US children's hospitals' neonatal and pediatric intensive care units. Am J Infect Control 2001; 29 (03) 152-157
  • 5 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56 (06) 893-897
  • 6 Performance Standards for Antimicrobial Susceptibility Testing: Twenty-third Informational Supplement. Clin Lab Stand Inst 2015; 33 (01) 100-123
  • 7 Limper HM, Barton G, McGinty M. , et al. Behavioral intention of physician trainees and medical students to practice hand hygiene. Infect Control Hosp Epidemiol 2013; 34 (10) 1102-1105
  • 8 Magill SS, Edwards JR, Bamberg W. , et al; Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014; 370 (13) 1198-1208
  • 9 World Health Organization (WHO)/The United Nations Children's Fund (UNICEF). Global Action Plan for Prevention and Control of Pneumonia (GAPP). World Health Organization/The United Nations Children's Fund (UNICEF); 2009
  • 10 Mech K, Ojah J. A study on the awareness and practices of hand washing amongst mothers of under-five children in the slums of Guwahati city. J Evid Based Med Health 2016; 3 (24) 1075-1078
  • 11 Pati S, Kadam SS, Chauhan AS. Hand hygiene behavior among urban slum children and their care takers in Odisha, India. J Prev Med Hyg 2014; 55 (02) 65-68
  • 12 Jabbar U, Leischner J, Kasper D. , et al. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol 2010; 31 (06) 565-570
  • 13 Ray SK, Zaman FA, Laskar NB. Hand washing practices in two communities of two states of Eastern India: an intervention study. Indian J Public Health 2010; 54 (03) 126-130
  • 14 Wray J, Sensky T. Psychological functioning in parents of children undergoing elective cardiac surgery. Cardiol Young 2004; 14 (02) 131-139
  • 15 Utens EM, Versluis-Den Bieman HJ, Verhulst FC, Witsenburg M, Bogers AJ, Hess J. Psychological distress and styles of coping in parents of children awaiting elective cardiac surgery. Cardiol Young 2000; 10 (03) 239-244
  • 16 Shen NJ, Pan SC, Sheng WH. , et al. Comparative antimicrobial efficacy of alcohol-based hand rub and conventional surgical scrub in a medical center. J Microbiol Immunol Infect 2015; 48 (03) 322-328
  • 17 Pineles LL, Morgan DJ, Limper HM. , et al. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities. Am J Infect Control 2014; 42 (02) 144-147
  • 18 Miller MA, Hyland M, Ofner-Agostini M, Gourdeau M, Ishak M. ; Canadian Hospital Epidemiology Committee. Canadian Nosocomial Infection Surveillance Program. Morbidity, mortality, and healthcare burden of nosocomial Clostridium difficile-associated diarrhea in Canadian hospitals. Infect Control Hosp Epidemiol 2002; 23 (03) 137-140
  • 19 Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004; 17 (04) 863-893
  • 20 McLaws ML, Taylor PC. The Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot. J Hosp Infect 2003; 53 (04) 259-267
  • 21 Kim JM, Park ES, Jeong JS. , et al; Nosocomial Infection Surveillance Committee of the Korean Society for Nosocomial Infection Control. Multicenter surveillance study for nosocomial infections in major hospitals in Korea. Am J Infect Control 2000; 28 (06) 454-458