Prospective study to evaluate handwashing compliance in two Indian hospitals, in New Delhi and Bangalore

BACKGROUND: Patients admitted to hospitals are at risk of acquiring nosocomial infections. Many peer-reviewed studies show that handwashing (HW) significantly reduces hospital infections and mortality rates. At three intensive care units (ICUs) in two Indian hospitals, we measured the handwashing compliance before contact with patients. Our objective was to evaluate handwashing compliance to find differences between groups and activities. METHODS: One healthcare worker per hospital observed and filled in a specially designed form on the handwashing compliance of physicians, nursing staff, and ancillary staff before patient contact in three ICUs in two Indian hospitals. We analyzed the differences using univariate (UV) analysis. RESULTS: From July 2004 to November 2004, we observed 588 patient contacts. The overall handwashing compliance rate before patient contact was 74.8% (440/588). The rate for women was 77.7% (349/449) and for men was 65.5% (91/139) (RR: 1.19; IC 95% 0.94 – 1.50, p = 0.1442). Nursing staff 78.0% (329/422) versus physicians 74.1% (100/135) (RR: 1.05; IC 95% 0.84 – 1.32, p = 0.6541). Nursing staff 78.0% (329/422) versus ancillary staff 35.5% (11/31) (RR: 2.20; IC 95% 1.20 – 4.01., p = 0.0084). Physicians 74.1% (100/135) versus ancillary staff 35.5% (11/31) (RR: 2.09; IC 95% 1.12 – 3.89, p = 0.0178). Morning work shift 82.0% (168/205) versus afternoon shift 69.8% (155/222) (RR: 1.17; IC 95% 0.94 – 1.46, p = 0.1498). Morning work shift 82.0% (168/205) versus night shift 72.8% (117/161) (RR: 1.13; IC 95% 0.89 – 1.43, p = 0.0.3179). Afternoon work shift 69.8% (155/222) versus night shift 72.8% (117/161) (RR: 0.96; IC 95% 0.76 – 1.22, p = 0.0.1438). Superficial contact 71.5% (258/361) versus invasive contact 80.2% (182/227) (RR: 1.12; IC 95% 0.93 – 1.36, p = 0.2346). CONCLUSION: At these Indian hospitals, nursing staff more than ancillary staff and physicians more than ancillary staff are associated with significant handwashing compliance.