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Hand hygiene expectations in radiography: a critical evaluation of the opportunities for and barriers to compliance

Jeanes, A., Henderson, F., Drey, N. ORCID: 0000-0003-0752-9049 & Gould, D. J. (2019). Hand hygiene expectations in radiography: a critical evaluation of the opportunities for and barriers to compliance. Journal of Infection Prevention, 20(3), pp. 122-131. doi: 10.1177/1757177419836161


Introduction: Good hand hygiene practices reduce the risk of transmission of infection in healthcare. In common with other areas of healthcare, infection control knowledge and practice in radiography has potential for improvement. Regular hand hygiene compliance (HHC) monitoring indicated poor compliance in radiology which did not accurately reflect practice in one organisation. Using a quality improvement cycle, the process and context of work undertaken in radiology were examined in order to improve the validity and utility of HHC monitoring data collection process in the department.

Methods: Following examination of the evidence base and with agreement from the radiology team, the chest X-ray process was observed and actions notated. This was then scored using the organisation and the World Health Organization five moments of hand hygiene tool. An alternative risk-based scoring system was developed.

Results: The HHC score of 22% was obtained using standard measurements. Achievement of 100% compliance would require the radiographer to clean their hands nine times for each X-ray. The sequence of taking a chest X-ray was examined and two points in the process were identified as key points at which hand cleaning should take place to reduce the risk of transmission of infection.

Conclusions: Cleaning hands frequently to achieve compliance expectations in this short low-risk process is neither feasible nor beneficial. A pragmatic risk-based approach to hand hygiene expectations in predictable procedures such as taking a chest X-ray reduces ambiguity and potentially increases compliance.

Publication Type: Article
Additional Information: © The Author(s) 2019.
Publisher Keywords: Hand hygiene, compliance, radiographer, quality improvement, monitoring, sequence
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Nursing
SWORD Depositor:
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