Assessing the Effectiveness of Risk-Oriented Handwashing in Cardiac Surgery

Relevance. Healthcare-associated infections are a serious complication worldwide, with improper hand cleaning thought to be the main cause. Compliance with handwashing requirements is achieved in only 38% of cases. A risk management technology is the implementation of a standard operating procedure in practice, and an effective tool for analyzing non-compliance with its standards is an audit system that allows you to respond in a timely manner to existing deviations. The introduction of a system of audits of the epidemiological safety of medical technologies seems to be one of the directions of the risk-based approach to the prevention of infectious complications. Aim. To evaluate the effectiveness of hand sanitizing technology audits as a tool to reduce the risk of infections. Materials and methods . Over a three-year period, an audit of handwashing was carried out in four departments of the cardiac surgery center, during which 9924 checklists were analyzed. The audit itself took place according to the methodological recommendations we had previously developed. The audit results were processed in Microsoft Excel to form a database. Risk grading was carried out for each checklist using the risk matrix and the Percentile function in increments of 0.25 Results. During the audit, 5 items related to hand treatment technology were assessed: equipment of the workplace for hand treatment, hand treatment technology, the presence of antiseptic in areas of mandatory hand treatment, epidemiological safety during manipulation and patient care, organization of the hand treatment system. Initially, the risk in all positions was assessed as high, the implementation of corrective measures reduced the risk of infections associated with the provision of medical care to low values, and the incidence of infections in the cardiac surgery hospital decreased from 3.42 to 1.25 per 1000 patient days. Conclusion. The introduction of an audit system for hand sanitizing technology is an effective measure to reduce the risk of infection.