Investigating the Causes of Non- Observance of Hand Hygiene in the Intensive Care Unit and Effective Strategies to Reduce it in Hospitals Affiliated with Tehran University of Medical Sciences, 2018-2020

Introduction: The least expensive way to prevent hospital infections is hand hygiene. This study investigated the causes of non-observance of hand hygiene in the intensive care unit (ICU) department of the studied hospitals and effective strategies to reduce it. Materials and Methods: This interventional study was conducted in the ICU wards of six hospitals (A-F) affiliated with Tehran University of Medical Sciences, 2018-2020. In order to improve the process of hand hygiene, the - nine step FOCUS-PDCA method was used. In each hospital, hand hygiene compliance was measured in five different situations (before contact with the patient, before aseptic procedures, after contact with the patient fluids, after contact with the patient, and after contact with the environment), in three professional career subgroups before and after the implementation of the intervention, using the World Health Organization checklist by the trained people. The data were analyzed in SPSS software version 24. Results: In all the hospitals under study, the level of hand hygiene compliance in all five situations had a significantly increasing trend, so that at the end of the study in the six medical centers, the level of hand hygiene compliance reached above 41%. In all medical centers, nurses had the highest amount of hand washing. After the intervention, the average level of hand hygiene in all hospitals increased significantly (p