Date of Award

Summer 6-2011

Document type


Degree Name

Masters theses/dissertations - taught courses

First Supervisor

Jonathan Drennan

Second Supervisor

Pauline Joyce


Ministry of Health


hand hyigiene, hand wash, alcohol hand rub, infection control, dental clinincs, dental health workers


Abstract Health care associated infections affect hundreds of millions of people around the world and it is a major global issue for patient safety. Moreover, the most common way that micro-organisms (germs), particularly bacteria, are spread and cause infection is by being carried on people‘s hands. Hand hygiene is the most important measure to avoid the spread of harmful germs and to prevent ill health. Regular and thorough hand hygiene is always important when working in an environment or organization where health care is provided. So, having clean hands helps to protect patients, particularly the most vulnerable, as well as health care workers. This change project proposed to improve hand hygiene compliance among dental health care workers in three dental clinics in Khartoum State. This included increasing compliance to hand washing, as well as introducing another simple, quick and effective procedure of hand hygiene which is using alcohol hand rub. The hand hygiene compliance rate showed gradual improvement over time, starting from below standard hand hygiene at base line assessment (44%), to reach its maximum at 3 weeks post intervention assessment (94%). These results indicate that the systematic application of the change model and WHO multimodal strategies is associated with improvement in hand hygiene compliance of dental healthcare workers and thus it could result in a sustained positive impact. Doctors were found to have a better compliance to hand hygiene compared to nurses in all the assessment periods, which might reflect the need to intervene further specifically for nurses thus warranting the issue with further study and analysis. Although hand washing was found to be the preferred method for hand hygiene at 3 weeks into the intervention, yet the preference was reversed in the 3 weeks post intervention assessment to alcohol hand rub. In general, the literature suggests healthcare workers are possibly more concerned about their own safety than transmitting infection to patient. So we would expect to find better hand hygiene after patient contact compared to before patient contact. Yet in this project, they are found to be indifferent to the two indications with similar levels of compliance at baseline and post- intervention..

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A dissertation submitted in part fulfillment of the degree of MSc in Healthcare Management, Institute of Leadership, Royal College of Surgeons in Ireland, Dublin 2011.