Sardar Ali, Farouk Atiq.
Hand-hygiene practices in the operating theatre in a tertiary care hospital in a developing country: an observational study.
J Cardiovascular Dis Jul ;10(2):58-62.

A variety of infection control measures are practiced to decrease the risk of trans mission of pathogens in the hospital environment. Standard precautions are thought to be the most effective against healthcare-associated infections. However, compliance with standard precautions is not sufficiently high in healthcare setups in the third world countries. Frequent handwashing or use of alcohol based solutions is an important measure to reduce the risks of transmitting infectious organisms from one person to another, although it is not easy to maintain high compliance in healthcare settings. Studies of surgical site infections (SSIs) in Western countries report a relative frequency of 15%- 20% in prevalence studies and an incidence in general surgery that varies between 2%- 3% and 12%-15%, depending on the class of operation. A recent overview of 30 studies published between 1990 and 2002 on the outcome of nosocomial infection prevention through intervention programs found that approximately 20% of all infections were avoidable.1 Two of the western studies conducted in general surgery departments showed a reduction in the number of the infections by 24%-25% after implementation of an infection surveillance and control program.2,3 In Italy, a nationwide study of nosocomial infection surveillance and control programs launched in early 2000 reported that only 31% of surgery departments had established protocols for infection prevention.4 “Standard precautions” require that health care workers assume that the blood and body substances of all patients are potential sources of infection, regardless of the diagnosis, or presumed infectious status. Additional precautions are needed for diseases transmitted by air, droplets and contact. These are termed “additional (transmission-based) precautions”.5 Hand washing with soap (antimicrobial or nonantimicrobial) should be performed whenever there is visible contamination with blood or body fluids. Alcohol-based hand rubs are recommended for hand hygiene when there is no visible contamination. Spore-forming organisms such as Clostridium difficile and Bacillus anthracis are poorly inactivated by waterless hand hygiene products and require the physical action of washing and rinsing for removal.6,7 This study was carried out to assess the standard of applied infection control practices in terms of hand hygiene application in the operating rooms in a tertiary care hospital in a developing world country.

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