[Implementation of immediate feedback system into hand hygiene practice in the intensive care unit].

Introduction: Infections affect about 30-50% of intensive care unit patients resulting in substantial morbidity and mortality. Multimodal interventions proved to be successful in the prevention of healthcare-associated infections. Appropriate hand hygiene including correct disinfection technique and timing is essential. Aim: The aim of our study was to investigate the hand hygiene practice among the intensive care unit healthcare workers by immediate feedback system implementation and compliance study. Method: A 3-week-long observational study was conducted at the Department of Anaesthesiology and Intensive Therapy, Semmelweis University, during November and December, 2018. Data regarding hand hygiene technique were collected by using the Semmelweis Scanner technology, while compliance data were recorded by direct observations. Statistical analysis was performed by Kruskal-Wallis test, Fisher's exact test and chi(2)-test. Results: 604 measurements were recorded by the electronic system. Hand disinfection was appropriate in 86.5% of cases. The median value of coverage was 99.87%. The trend of these indices showed persistently high values. A lower error rate was observed in the physiotherapy group compared to others (doctors: p<0.01, nurses: p = 0.03, assistant nurses: p = 0.03). 162 opportunities were recorded during direct observations. The mean compliance rate was 60.49%, with the lowest among doctors (53.97%). The difference was non-significant compared to nurses (62.92%, p = 0.26). Conclusions: Hand hygiene technique during the study period was found to be highly and permanently appropriate, while compliance was lower than expected. The immediate feedback system may be useful in achieving appropriate hand disinfection technique, although further interventions are needed for higher compliance rates.