Hand hygiene practices in adult versus pediatric intensive care units at a university hospital before and after intervention.

Observations of hand hygiene practices of the health care workers (HCWs) were carried out at a tertiary care center by a single observer in all adult and pediatric intensive care units (ICUs) before and after educational programs. Access to alcohol-based hand rub was also increased. A survey of HCWs was carried out to determine knowledge of hand hygiene. Before interventions, mean adherence to hand hygiene in all ICUs was 54% with significant difference between adult and pediatric ICUs (p<.0001) (35% vs 90%, respectively). Traditional handwashing versus alcohol-based hand rub use was 72% versus 28%, respectively. Following the interventions, there was a significant increase (p<.0001) in hand hygiene adherence in adult ICUs (81%). 46% of survey respondents believed that alcohol-based hand rub could not be used for methicillin resistant Staphylococcus aureus infection and 21% believed that alcohol-based hand rub could be used if hands were soiled. Overall, adherence to hand hygiene in adult ICUs improved with institution of an educational program and increase in accessibility of alcohol-based hand rub. There was a statistically significant increase in the frequency of alcohol-based hand rub use; however, traditional handwashing was still preferred. The survey of HCWs revealed gaps in knowledge regarding methods of hand hygiene.