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Reducing post-cesarean wound infection at Muhororo Hospital by increasing hand hygiene practice

Adelphine Nibamureke (Muhororo Hospital, Muhororo, Rwanda)
Egide Kayonga Ntagungira (School of Health Sciences, University of Rwanda College of Medicine and Health Sciences, Rwanda)
Eva Adomako (Global Health Leadership Institute, Yale University, New Haven, Connecticut, USA)
Victor Pawelzik (Global Health Leadership Institute, Yale University, New Haven, Connecticut, USA)
Rex Wong (Global Health Leadership Institute, Yale University, New Haven, Connecticut, USA)

On the Horizon

ISSN: 1074-8121

Publication date: 12 September 2016

Abstract

Purpose

Post-cesarean wound infection (PCWI) is a common post-operative complication that can negatively affect patients and health systems. Poor hand hygiene practice of health care professionals is a common cause of PCWI. This case study aims to describe how strategic problem solving was used to introduce an alcohol-based hand rub in a district hospital in Rwanda to improve hand hygiene compliance among health care workers and reduce PCWI.

Design/methodology/approach

Pre- and post-intervention study design was used to address the poor hand hygiene compliance in the maternity unit. The hospital availed an alcohol-based hand rub and the team provided training on the importance of hand hygiene. A chart audit was conducted to assess the PCWI, and an observational study was used to assess hand hygiene compliance.

Findings

The intervention successfully increased hand hygiene compliance of health care workers from 38.2 to 89.7 per cent, p < 0.001, and was associated with reduced hospital-acquired infection rates from 6.2 to 2.5 per cent, p = 0.083.

Practical implications

This case study describes the implementation process of a quality improvement project using the eight steps of strategic problem solving to introduce an alcohol-based hand rub in a district hospital in Rwanda. The intervention improved hand hygiene compliance among health care workers and reduced PCWI using available resources and effective leadership skills.

Originality/value

The results will inform hospitals with similar settings of steps to create an environment that enables hand hygiene practice, and in turn reduces PCWI, using available resources and strategic problem solving.

Keywords

Acknowledgements

The authors thank the Government of Rwanda, Ministry of Health and Muhororo Hospital for their support in this project. The authors also want to thank all the staff who participated in this project for their effort and contribution.

Citation

Nibamureke, A., Kayonga Ntagungira, E., Adomako, E., Pawelzik, V. and Wong, R. (2016), "Reducing post-cesarean wound infection at Muhororo Hospital by increasing hand hygiene practice", On the Horizon, Vol. 24 No. 4, pp. 357-362. https://doi.org/10.1108/OTH-07-2016-0039

Publisher

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Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited