Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 6 Issue 2

Impact of Kaizen/CQI On Improving Adherence to Hand Hygiene Protocol Among Staff and Students at Kabale Hospital Uganda

Ediau John1, Bako Lilian2*, Namutebi Anne Marion3, Take Naoki4 and Namasopo Sophie Oleja5

1Department of Surgery, Kabale Regional Referral Hospital, Uganda
2Quality Improvement Department, Kabale Regional Referral Hospital, Uganda
3Department of Internal Medicine/Research, Kabale Regional Referral Hospital, Uganda
4Japan International Cooperation Agency, Uganda Office, Uganda
5Department of Administration, Kabale Regional Referral Hospital, Uganda

*Corresponding Author: Bako Lilian, Quality Improvement Department, Kabale Regional Referral Hospital, Uganda.

Received: October 25, 2021; Published: January 12, 2022


Background: Health care-associated infections (HAI) occur worldwide and affect both developed and developing countries, and in developed countries, between 5% and 10% of patients acquire one or more infections, resource- limited settings, rates of infection can exceed 20%. Simple measures like appropriate hand hygiene can limit nosocomial infections.

Method: In this prospective cross-sectional study, a survey was conducted in some clinical areas of the hospital using the standard WHO hand hygiene observation form (based on the 5 moments of hand hygiene) in the month of December 2018. Targeting all professional categories. The reports were analyzed using excel and the denominator is number of opportunities while numerator, the number of actions

Results: The results of the study showed 22% as an average compliance rate to hand hygiene protocol by staff and students.

Nurses who were assessed, opportunities were 14 with 0 action representing 0%. The student nurse’s available opportunities were 11 with actions of 1 representing 09%. The medical students were assessed with opportunity of 02 and actions of 00 representing 0%. The medical officers (doctors) had 10 opportunities with actions of 01 representing 10%. The cadres of orthopedic had 06 opportunities with 00 actions leading to 0%. The midwives had 33 opportunities with 05 actions representing a percentage of 15%. Other cadres like counselors, data officer was with 01 opportunities with 00 action representing 0%. Other medical technicians e.g., lab technicians, dieticians had 03 opportunities with 02 action representing 66.7%.

Discussion: The above results show that ophthalmic staffs were better than others in adhering to hand hygiene practices whereas laboratory staff, dispensers and radiologist were performing averagely. while others are below standard in adhering to hand hygiene practices.

Conclusion: The reason for conducting the above assessment is from the background that one of the contributing factors to hospital acquired infections (HAIs) is as a result of poor hand hygiene practices by health workers leading to antimicrobial resistance.

Keywords: Hand Hygiene; Kaizen; Continuous Quality Improvement; Health Care Associated Infections; Patient Safety; PDSA Cycle


  1. Uganda national infection prevention guideline (2013).
  2. Boyce JM and Pittet D. “Guideline for hand hygiene in health care settings: recommendations” (2002).
  3. Tikhomirov E. “WHO Programme for the control of hospital infections”. Chemiotherapia 3 (1987): 148-151.
  4. Vincent JL. “Nosocomial infections affects 30% of patients in intensive care units”. Lancet 361 (2003): 2068-2077.
  5. Lazzari S., et al. “Making hospitals safer: the need for a global strategy for infection control in healthcare settings”. World Hospitals and Health Services2 (2004): 32, 34, 36- 42.
  6. Pittet D. “Infection control and quality health care in the new millennium”. American Journal of Infection 5 (2005): 258-267.
  7. MOH Uganda/IDI Survey Report June (2019).
  8. Quality improvement/IPC survey report December (2018).
  9. “Patient Safety Solutions” 1.9 (2007).
  10. World Alliance for Patient Safety.
  11. World Health Organization. “HH-Observation Tool” (2009).
  12. Graban M and Swartz JE. “Healthcare KAIZEN: Engaging Front Line staff in Sustainable Continuous Improvement” (2012).
  13. Hasegawa T., et al. “Change Management for Hospitals - Through Stepwise Approach, 5S-KAIZEN-TQM”. Japan International Cooperation Agency, Tokyo, Japan (2013).
  14. Ministry of Health and Social Welfare. “Implementation Guideline for 5S-KAIZEN-TQM Approaches in Tanzania, Dar es Salaam, United Republic of Tanzania” (2013).
  15. Taylor Ron. “The KAIZEN Facilitators: How to Manage a KAIZEN Event for Maximum Results and Effective Organizational Change, Amazon, USA” (2012).
  16. Weber DO. “Toyota-style Management Drivers Virginia Mason”. The Physician Executive (2006): 12-17.
  17. Isigima. Kaizen presentations for TOT November 2018, Mbeya Tanzania (2018).
  18. Monthly quality improvement meeting minutes for Kabale Regional Referral Hospital, month of March (2019).
  19. World Health Organization hand hygiene observation form page two (general recommendations)/hand hygiene technical reference manual).
  20. Lucy K Tuntam., et al. “Barriers and opportunities for sustainable hand hygiene interventions in rural Liberian hospitals”. International Journal of Environmental Research and Public Health16 (2021).
  21. H Saito. “Hand hygiene compliance among health practitioners and the incidence of hospital acquired infections at Mbale Regional Referral Hospital, Uganda in 2017”.
  22. De Pauw., et al. “On behalf of working group hand hygiene BAPCOC (Belgium antibiotic policy coordination committee.)”.
  23. National survey report by infectious disease institute in the months of October 2019 and January (2019).


Citation: Bako Lilian., et al. “Impact of Kaizen/CQI On Improving Adherence to Hand Hygiene Protocol Among Staff and Students at Kabale Hospital Uganda”.Acta Scientific Medical Sciences 6.2 (2022): 52-57.


Copyright: © 2021 Bako Lilian., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US