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Multicenter Study
. 2023 Mar 2;20(5):4435.
doi: 10.3390/ijerph20054435.

A Multifaceted Approach to the "Bare below the Elbow" Concept and Hand Hygiene Compliance among Healthcare Professionals-Multicenter Population-Based Study

Emilia Szumska  1 , Przemyslaw Czajkowski  2 , Michal Zablocki  1 , Dorota Rozkiewicz  3
Affiliations
Multicenter Study

A Multifaceted Approach to the "Bare below the Elbow" Concept and Hand Hygiene Compliance among Healthcare Professionals-Multicenter Population-Based Study

Emilia Szumska et al. Int J Environ Res Public Health. .

Abstract

Nosocomial infections remain an important issue for patient safety concerns. Since hospital infections are mainly connected with healthcare professionals' routines, an increase in hand hygiene effectiveness through compliance with the "bare below the elbow" (BBE) concept could reduce the number of nosocomial infections. Therefore, this study aims to evaluate hand hygiene and to investigate healthcare professionals' compliance with the BBE concept. We performed our study on a group of 7544 hospital professionals involved in patient care. During the national preventive action, questionnaires, demographic data, and hand hygiene preparations were recorded. Hand disinfection was verified by COUCOU BOX, containing a UV camera. We noted that 3932 (52.1%) persons complied with the BBE rules. Nurses and non-medical personnel were significantly more often classified as BBE rather than non-BBE (2025; 53.3% vs. 1776; 46.7%, respectively, p = 0.001 and 1220; 53.7% vs. 1057; 46.3%, p = 0.006). Different proportions were demonstrated for the groups of physicians-non-BBE (783; 53.3%) compared to BBE (687; 46.7%) (p = 0.041). Healthcare workers from the BBE group statistically more often disinfected their hands correctly (2875/3932; 73.1%) compared to the non-BBE group (2004/3612; 55.5%) (p < 0.0001). This study demonstrates the positive impact of compliance with the BBE concept on effective hand disinfection and patient safety. Therefore, education and infection-prevention actions should be popularized to improve the BBE policy's effectiveness as well.

Keywords: BBE; antiseptics; bare below the elbow; disinfection; hand hygiene; infection prevention.

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Conflict of interest statement

E.S. and M.Z. are employees of Medilab Sp. z o. o. All other authors declare that there are no potential conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
The frequency of adherence to the BBE policy depends on the person’s profession and place of work (LTCFs—long-term-care facilities).
Figure 2
Figure 2
The frequency of compliance with the BBE policy among hospital medical personnel (other—administration, radiology, laboratory, pharmacy; ICU—intensive care unit; ED—emergency department). Black color—non-BBE group; red color—BBE group.
Figure 3
Figure 3
The frequency of adherence to the BBE policy depends on the personnel’s profession and place of work (other—administration, radiology, laboratory, pharmacy; ICU—intensive care unit; ED—emergency department). Black color—non-BBE group; red color—BBE group.
Figure 4
Figure 4
The frequency of hand disinfection in various professional groups, depending on the adherence to BBE compliance.
See this image and copyright information in PMC

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