ORIGINAL ARTICLE

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

Andaru Dahesihdewi , Iwan Dwiprahasto, Supra Wimbarti, Budi Mulyono

Andaru Dahesihdewi
Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia Clinical Epidemiology and Bio Statistic Unit, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia. Email: adahesihdewi@yahoo.com

Iwan Dwiprahasto
Clinical Epidemiology and Bio Statistic Unit, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia Department of Pharmacology and Therapy, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia

Supra Wimbarti
Clinical Epidemiology and Bio Statistic Unit, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia Faculty of Psychology, Gadjah Mada University, Yogyakarta, Indonesia

Budi Mulyono
Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
Online First: April 15, 2018 | Cite this Article
Dahesihdewi, A., Dwiprahasto, I., Wimbarti, S., Mulyono, B. 2018. Reducing Methicillin-Resistant Staphylococcus Aureus (MRSA) Cross-Infection through Hand Hygiene Improvement in Indonesian Intensive Tertiary Care Hospital. Bali Medical Journal 7(1): 227-233. DOI:10.15562/bmj.v7i1.782


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 signifcantly improved practical accuracy-consistency-sustainability, after intervention in the initial and end-evaluations. There was a
signifcant 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 signifcantly. It suggested cross-infection can be used as an indicator of hand hygiene compliance.

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