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Background: Hand hygiene is a noncomplex and a cost-effective way to prevent hospital-acquired infection (HAI). The incidence of hospital acquired MRSA (HA-MRSA) cross-infection is an indicator directly measure the hand hygiene practice at the point of care. Objective: Our study aimed to evaluate the impact of hand hygiene compliance on HA-MRSA cross transmission in the intensive tertiary care of Dr. Sardjito General Hospital, Gadjah Mada University teaching hospital, Yogyakarta, Indonesia. Methods: A quasi-experimental before-after design was conducted to evaluate the implementation of the WHO multimodal hand hygiene improvement strategy which was adjusted to the local needs, based on the qualitative study result from the intensive care from June 2014 to April 2016. All workers who have frequent contact with patients were observed for their hand hygiene compliance by trained observers. The incidence of HA-MRSA was recorded through active surveillance accompanied by microbiology data. Results: There were 92 healthcare workers (18 medical doctors, 45 nurses, 29 other staffs) and 5,280 patients involved throughout the study period. There were 16,313 hand hygiene opportunity observations which resulted in a significantly improved practical accuracy-consistency-sustainability, after intervention in the initial and end-evaluations. There was a significant decrease in the HA-MRSA rate from 12.6% before intervention to 1.2% and 0.3% at the initial and end-evaluations, respectively. Conclusion: Increasing hand hygiene compliance in intensive care reduced HA-MRSA significantly. It suggested cross-infection can be used as an indicator of hand hygiene compliance.

bali medical journal

Reducing Methicillin-Resistant Staphylococcus Aureus (MRSA) Cross-Infection through Hand Hygiene Improvement in Indonesian Intensive Tertiary Care Hospital