Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit

2008 ◽  
Vol 36 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Arjun K. Venkatesh ◽  
Mary G. Lankford ◽  
Denise M. Rooney ◽  
Todd Blachford ◽  
Charles M. Watts ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Vancomycin Resistant Enterococcus ◽  
Electronic Alerts ◽  
Vancomycin Resistant ◽  
Hygiene Compliance

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals Hand hygiene and the sequence of patient care

2021 ◽  
pp. 1-6
Author(s):  
Nai-Chung Chang ◽  
Michael Jones ◽  
Heather Schacht Reisinger ◽  
Marin L. Schweizer ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Patient Care ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Resistant Bacteria ◽  
Surgical Intensive Care ◽  
Hygiene Compliance ◽  
Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

scholarly journals Intranasal Antiseptic and Universal Antiseptic Baths Are Effective in Reducing MRSA Acquisition in Extended-Care Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s304-s305
Author(s):  
Angela Chow ◽  
Wei Zhang ◽  
Joshua Wong ◽  
Brenda Ang
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Care Facility ◽  
Clinical Problem ◽  
Clinical Samples ◽  
Extended Care ◽  
Care Facilities ◽  
The Mean ◽  
Hygiene Compliance

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing clinical problem in rehabilitation hospitals, where patients stay for extended periods for intensive rehabilitation therapy. In addition to cutaneous sites, the nares could be a source for nosocomial MRSA transmission. Decolonization of nasal and cutaneous reservoirs could reduce MRSA acquisition. We evaluated the effectiveness of topical intranasal octenidine gel, coupled with universal chlorhexidine baths, in reducing MRSA acquisition in an extended-care facility. Methods: We conducted a quasi-experimental before-and-after study from January 2013 to June 2019. All patients admitted to a 100-bed rehabilitation hospital specialized in stroke and trauma care in Singapore were screened for MRSA colonization on admission. Patients screened negative for MRSA were subsequently screened at discharge for MRSA acquisition. Screening swabs were obtained from the nares, axillae, and groin and were cultured on selective chromogenic agar. Patients who tested positive for MRSA from clinical samples collected >3 days after admission were also considered to have hospital-acquired MRSA. Universal chlorhexidine baths were implemented throughout the study period. Intranasal application of octenidine gel for MRSA colonizers for use for 5 days from admission was added to the hospital’s protocol beginning in September 2017. An interrupted time series with segmented regression analysis was performed to evaluate the trends in MRSA acquisition before the intervention (January 2013–July 2017) and after the intervention (September 2017–June 2019) with intranasal octenidine. August 2017 was excluded from the analysis because the intervention commenced midmonth. Results: In total, 77 observational months (55 before the intervention and 22 after the intervention) were included. The mean monthly MRSA acquisition rates were 7.0 per 1,000 patient days before the intervention and 4.4 per 1,000 patient days after the intervention (P < .001), with a mean number of patient days of 2,516.3 per month before the intervention and 2,427.2 per month after the intervention (P = .0172). The mean monthly number of MRSA-colonized patients on admission to the hospital decreased from 24.8 before the intervention to 18.7 after the intervention (P < .001). Mean monthly hand hygiene compliance rate increased significantly from 65.7% before the intervention to 87.4% after the intervention (P < .001). After adjusting for the number of MRSA-colonized patients on admission and hand hygiene compliance rates, a constant trend was observed from January 2013 to July 2017 (adjusted mean coefficient, 0.012; 95% CI, −0.037 to 0.06), with an immediate drop in September 2017 (adjusted mean coefficient, −2.145; 95% CI, −0.248 to −0.002; P = .033), followed by a significant reduction in MRSA acquisition after the intervention from September 2017 through June 2019 (adjusted mean coefficient, −0.125; 95% CI, -4.109 to -0.181; P = .047). Conclusions: Topical intranasal octenidine, coupled with universal chlorhexidine baths, can reduce MRSA acquisition in extended-care facilities. Further studies should be conducted to validate the findings in other healthcare settings.Funding: NoneDisclosures: None

scholarly journals Improving hand hygiene in hospitals: comparing the effect of a nudge and a boost on protocol compliance

2021 ◽  
pp. 1-23
Author(s):  
Henrico van Roekel ◽  
Joanne Reinhard ◽  
Stephan Grimmelikhuijsen
Keyword(s):  
Hand Hygiene ◽  
Behavioral Interventions ◽  
Hand Hygiene Compliance ◽  
Hospital Nurses ◽  
Improve Hand Hygiene ◽  
Policy Practice ◽  
Effective Interventions ◽  
Risk Literacy ◽  
Hygiene Compliance ◽  
Hospital Wards

Abstract Nudging has become a well-known policy practice. Recently, ‘boosting’ has been suggested as an alternative to nudging. In contrast to nudges, boosts aim to empower individuals to exert their own agency to make decisions. This article is one of the first to compare a nudging and a boosting intervention, and it does so in a critical field setting: hand hygiene compliance of hospital nurses. During a 4-week quasi-experiment, we tested the effect of a reframing nudge and a risk literacy boost on hand hygiene compliance in three hospital wards. The results show that nudging and boosting were both effective interventions to improve hand hygiene compliance. A tentative finding is that, while the nudge had a stronger immediate effect, the boost effect remained stable for a week, even after the removal of the intervention. We conclude that, besides nudging, researchers and policymakers may consider boosting when they seek to implement or test behavioral interventions in domains such as healthcare.

Hand hygiene compliance by physicians: Marked heterogeneity due to local culture?

2009 ◽  
Vol 37 (4) ◽  
pp. 301-305 ◽  
Author(s):  
Dror Cantrell ◽  
Oded Shamriz ◽  
Matan J. Cohen ◽  
Zvi Stern ◽  
Colin Block ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Local Culture ◽  
Hygiene Compliance
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