Hand Hygiene (HH) has been described as the cornerstone and starting point in all infection control. Compliance to HH is a fundamental quality indicator. The aim of this study was to investigate the HH compliance among Health-care Workers (HCWs) in Benin surgical care units. A multicenter prospective observational study was conducted for two months. The World Health Organization (WHO) Hand Hygiene Observation Tool was used in obstetric and gastrointestinal surgery through six public hospitals in Benin. HH compliance was calculated by dividing the number of times HH was performed by the total number of opportunities. HH technique and duration were also observed. A total of 1315 HH opportunities were identified during observation period. Overall, the compliance rate was 33.3% (438/1315), without significant difference between professional categories (nurses =34.2%; auxiliaries =32.7%; and physicians =32.4%; p = 0.705). However, compliance rates differed (p < 0.001) between obstetric (49.4%) and gastrointestinal surgery (24.3%). Generally, HCWs were more compliant after body fluid exposure (54.5%) and after touching patient (37.5%), but less before patient contact (25.9%) and after touching patient surroundings (29.1%). HCWs were more likely to use soap and water (72.1%) compared to the alcohol based hand rub solution (27.9%). For all of the WHO five moments, hand washing was the most preferred action. For instance, hand rub only was observed 3.9% after body fluid exposure and 16.3% before aseptic action compared to hand washing at 50.6 and 16.7% respectively. Duration of HH performance was not correctly adhered to 94% of alcohol hand rub cases (mean duration 9 ± 6 s instead of 20 to 30 s) and 99.5% of hand washing cases (10 ± 7 s instead of the recommended 40 to 60 s). Of the 432 HCWs observed, 77.3% followed HH prerequisites (i.e. no artificial fingernails, no jewellery). We also noted a lack of permanent hand hygiene infrastructures such as sink, soap, towels and clean water. Compliance in surgery was found to be low in Benin hospitals. They missed two opportunities out of three to apply HH and when HH was applied, technique and duration were not appropriate. HH practices should be a priority to improve patient safety in Benin.

中文翻译：

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贝宁手术中的手部卫生：机遇与挑战。

手部卫生（HH）被描述为所有感染控制的基石和起点。符合HH是基本的质量指标。这项研究的目的是调查贝宁外科护理单位中医护人员（HCW）对HH的依从性。进行了为期两个月的多中心前瞻性观察研究。贝宁的六家公立医院将世界卫生组织（WHO）的手卫生观察工具用于产科和胃肠道手术。通过将执行HH的次数除以机会总数来计算HH遵从性。还观察到HH技术和持续时间。在观察期间共发现1315个HH机会。总体而言，达标率为33.3％（438/1315），在专业类别之间没有显着差异（护士= 34.2％；助剂= 32.7％；医生= 32.4％； p = 0.705）。但是，产科（49.4％）和胃肠道手术（24.3％）之间的依从率存在差异（p <0.001）。通常，接触体液后（54.5％）和接触患者后（37.5％）的HCW顺应性更高，但是在接触患者之前（25.9％）和接触患者环境后（29.1％）的顺应性较低。与基于酒精的手揉搓溶液（27.9％）相比，卫生保健工作者更可能使用肥皂和水（72.1％）。对于世卫组织的所有五个时刻，洗手是最可取的措施。例如，相比于分别为50.6和16.7％的洗手液，在接触体液后仅观察到3.9％，在无菌操作前仅观察到16.3％。94％的酒精洗手案例（平均持续时间为9±6 s而不是20至30 s）和99.5％的洗手案例（10±7 s而非建议的40到60 s）没有正确遵循HH性能的持续时间）。在观察到的432名HCW中，有77.3％符合HH先决条件（即没有人工指甲，没有珠宝）。我们还注意到缺乏永久性手卫生基础设施，例如水槽，肥皂，毛巾和清洁水。贝宁医院发现手术依从性较低。他们错过了三分之二的应用HH的机会，而当应用HH时，技术和持续时间不合适。在贝宁，HH实践应是提高患者安全性的优先事项。3％遵循HH先决条件（即没有人工指甲，没有珠宝）。我们还注意到缺乏永久性手卫生基础设施，例如水槽，肥皂，毛巾和清洁水。贝宁医院发现手术依从性较低。他们错过了三分之二的应用HH的机会，而当应用HH时，技术和持续时间不合适。在贝宁，HH实践应是提高患者安全性的优先事项。3％遵循HH先决条件（即没有人工指甲，没有珠宝）。我们还注意到缺乏永久性手卫生基础设施，例如水槽，肥皂，毛巾和清洁水。贝宁医院发现手术依从性较低。他们错过了三分之二的应用HH的机会，而当应用HH时，技术和持续时间不合适。在贝宁，HH实践应是提高患者安全性的优先事项。