English summary: Adherence to surgical hand rubbing directives in public hospitals in Southwest Finland

Background

The primary objective was to evaluate the adherence to surgical hand rubbing (SHR) directives among operating room personnel in public hospitals in Southwest Finland and to establish whether there are sections in these instructions that are inadequately followed. The secondary objective was to evaluate the effectiveness of feedback sessions in enhancing compliance with these directives.

Methods

Before-after intervention study.

Systematic observations of SHR practices among operating room personnel were performed in eight surgical services in public hospitals in Southwest Finland. Feedback sessions of the results were arranged for all the surgical services. To evaluate the effectiveness of these feedback sessions a second round of observations was performed in one surgical service.

Our study included all operating room personnel who were carrying out SHR before participating in sterile operations during our observation periods.

Results

In the first observation round, in 58% of the observed events operating room personnel did not use the three minutes recommended by WHO for SHR. In total, 76% of doctors and 34% of surgical nurses did not use the recommended time for disinfection, median times were 1.83 minutes (0-5.73 minutes) and 3.42 minutes (1.02-8.25 minutes), respectively (p<0.0001). Techniques of SHR differed greatly from instructions. No statistically significant improvement was found after the feedback sessions.

Conclusions

There were great shortcomings in the performance of SHR in our study population. To our knowledge, this is the first study to research adherence to SHR instructions. More observational studies are needed to determine if this is a general trend in surgical settings.