Investigation of the current hand hygiene compliance of cleaning staff in acute care hospitals in Germany: A multi-method observational study

Hand hygiene is a key measure for preventing nosocomial infections. While it has already been examined in numerous studies for medical staff, there is currently little systematic data available for cleaning staff, even though this occupational group also regularly works in sensitive hospital areas. The aim of the study is therefore to investigate hand hygiene compliance among cleaning staff in acute somatic hospitals in Germany. Compliance is considered at three different levels: 1. implementation of a hand hygiene measure, 2. selection of the appropriate measure for the indication, and 3. correct implementation. In addition, a microbiological examination of the hands is carried out to describe the observed behaviours. The study is designed as a quantitative, non-interventional observational study with microbiological supplementation. Data collection takes place during the regular working day without changing existing work processes. Hand hygiene compliance is recorded by means of structured observation using a standardised observation sheet. In addition, non-invasive contact samples are taken from the hands to determine the total bacterial count and the aggregated detection of hygiene-relevant bacteria (Staphylococcus spp., in particular MRSA). The study population comprises approximately 150 cleaning staff from several hospitals belonging to one operator, who are primarily involved in cleaning patient rooms. The results will be evaluated exclusively at an aggregated level. For methodological reasons, participants will be informed in advance in a general and comprehensible manner about the conduct of a hygiene study, without disclosing specific observation criteria, in order to reduce behavioural bias. The expected gain in knowledge lies in the differentiated description of hand hygiene compliance among this previously little-studied occupational group. The results are intended to provide an evidence-based foundation for future target group-specific training measures, interventions and further studies.