Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

2017 ◽  
Vol 38 (12) ◽  
pp. 1420-1427 ◽  
Author(s):  
Anthony Staines ◽  
Isabelle Amherdt ◽  
Estelle Lécureux ◽  
Christiane Petignat ◽  
Philippe Eggimann ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Substantial Improvement ◽  
Hand Hygiene Improvement ◽  
Promotional Strategy ◽  
Multicenter Analysis ◽  
Hygiene Compliance ◽  
Trained Observers ◽  
Education Performance

OBJECTIVETo assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative.DESIGNMulticenter analysis of hand hygiene compliance through direct observation by trained observers.SETTINGA total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland.PARTICIPANTSClinical staff.INTERVENTIONSIn total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449–6,852). An 18-month Hand Hygiene Breakthrough Collaborative was conducted to implement the WHO multimodal promotional strategy including improved access to alcohol-based hand rub, education, performance measurement and feedback, reminders and communication, leadership engagement, and safety culture.RESULTSOverall hand hygiene compliance improved from 61.9% to 88.3% (P<.001) over 18 months and was sustained at 88.9% (P=.248) 12 months after the intervention. Hand hygiene compliance among physicians increased from 62% to 85% (P<.001) and finally 86% at follow-up (P=.492); for nursing staff, compliance improved from 64% to 90% (P<.001) and finally 90% at follow-up (P=.464); for physiotherapists compliance improved from 50% to 90% (P<.001) and finally 91% at follow-up (P=.619); for X-ray technicians compliance improved from 45% to 80% (P<.001) and finally 81% at follow-up (P=.686). Hand hygiene compliance also significantly increased with sustained improvement across all hand hygiene indications and all hospitals.CONCLUSIONSA rigorously conducted multicenter project combining the Breakthrough Collaborative method for its structure and the WHO multimodal strategy for content and measurement was associated with significant and substantial improvement in compliance across all professions, all hand hygiene indications, and all participating hospitals.Infect Control Hosp Epidemiol 2017;38:1420–1427

scholarly journals Access to Alcohol-Based Hand Rub Is Associated With Improved Hand Hygiene in an Ebola-Threatened District of Western Uganda

2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Wide Distribution ◽  
Patient Contact ◽  
Improve Hand Hygiene ◽  
Before And After ◽  
Hygiene Compliance ◽  
Handwashing With Soap

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan

Hand hygiene promotion delivered by change agents—Two attitudes, similar outcome

2020 ◽  
Vol 41 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Yew Fong Lee ◽  
Mary-Louise McLaws ◽  
Loke Meng Ong ◽  
Suraya Amir Husin ◽  
Hock Hin Chua ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Tertiary Care ◽  
Change Agents ◽  
Controlled Study ◽  
Care Hospital ◽  
Hand Hygiene Improvement ◽  
Significant Difference ◽  
Hygiene Promotion ◽  
Hygiene Compliance

AbstractObjective:To assess the effect of peer-identified change agents (PICAs) compared to management-selected change agents (MSCAs) on hand hygiene behavior in acute care.Design:Randomized-controlled study.Setting:Two internal medicine wards of a public, university-affiliated, tertiary-care hospital in Malaysia.Methods:We randomly allocated 2 wards to hand hygiene promotion delivered either by PICAs (study arm 1) or by MSCAs (study arm 2). The primary outcome was hand hygiene compliance using direct observation by validated auditors. Secondary outcomes were hand hygiene knowledge and observations from ward tours.Results:Mean hand hygiene compliance in study arm 1 and study arm 2 improved from 48% (95% confidence interval [CI], 44%–53%) and 50% (95% CI, 44%–55%) in the preintervention period to 66% (63%–69%) and 65% (60%–69%) in the intervention period, respectively. We detected no statistically significant difference in hand hygiene improvement between the 2 study arms. Knowledge scores on hand hygiene in study arm 1 and study arm 2 improved from 60% and 63% to 98% and 93%, respectively. Staff in study arm 1 improved hand hygiene because they did not want to disappoint the efforts taken by the PICAs. Staff in study arm 2 felt pressured by the MSCAs to comply with hand hygiene to obtain good overall performance appraisals.Conclusion:Although the attitude of PICAs and MSCAs in terms of leadership, mode of action and perception of their task by staff were very different, or even opposed, both PICAs and MSCAs effectively changed behavior of staff toward improved hand hygiene to comparable levels.

Measuring Healthcare Worker Hand Hygiene Activity: Current Practices and Emerging Technologies

2011 ◽  
Vol 32 (10) ◽  
pp. 1016-1028 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Electronic Monitoring ◽  
Monitoring Systems ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Gold Standard Method ◽  
Improvement Programs ◽  
Hygiene Compliance

Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of multidisciplinary hand hygiene improvement programs. Observational surveys conducted by trained personnel are currently considered the “gold standard” method for establishing compliance rates, but they are time-consuming and have a number of shortcomings. Monitoring hand hygiene product consumption is less time-consuming and can provide useful information regarding the frequency of hand hygiene that can be used to give caregivers feedback. Electronic counting devices placed in hand hygiene product dispensers provide detailed information about hand hygiene frequency over time, by unit and during interventions. Electronic hand hygiene monitoring systems that utilize wireless systems to monitor room entry and exit of healthcare workers and their use of hand hygiene product dispensers can provide individual and unit-based data on compliance with the most common hand hygiene indications. Some systems include badges (tags) that can provide healthcare workers with real-time reminders to clean their hands upon entering and exiting patient rooms. Preliminary studies suggest that use of electronic monitoring systems is associated with increased hand hygiene compliance rates and that such systems may be acceptable to care givers. Although there are many questions remaining about the practicality, accuracy, cost, and long-term impact of electronic monitoring systems on compliance rates, they appear to have considerable promise for improving our efforts to monitor and improve hand hygiene practices among healthcare workers.

scholarly journals Observing and Improving Hand Hygiene Compliance Implementation and Refinement of an Electronic-Assisted Direct-Observer Hand Hygiene Audit Program

2013 ◽  
Vol 34 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Luke F. Chen ◽  
Charlene Carriker ◽  
Russell Staheli ◽  
Pamela Isaacs ◽  
Brandon Elliott ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Data Entry ◽  
Wireless Data ◽  
Intranet Portal ◽  
Hygiene Compliance ◽  
Trained Observers ◽  
Audit Program

We implemented a direct-observer hand hygiene audit program that used trained observers, wireless data entry devices, and an intranet portal. We improved the reliability and utility of the data by standardizing audit processes, regularly retraining auditors, developing an audit guidance tool, and reporting weighted composite hand hygiene compliance scores.

scholarly journals Impact of WHO Hand Hygiene Improvement Program Implementation: A Quasi-Experimental Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Farinaz Farhoudi ◽  
Anahita Sanaei Dashti ◽  
Minoo Hoshangi Davani ◽  
Nadiyeh Ghalebi ◽  
Golnar Sajadi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Teaching Hospital ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Tertiary Teaching ◽  
Before And After ◽  
Tertiary Teaching Hospital ◽  
Hygiene Compliance

Objectives. As affirmed by the World Health Organization (WHO), hand hygiene is the most powerful preventive measure against healthcare-associated infections (HCAIs) and, thus, it has become one of the five key elements of patient safety program. The aim is to assess the effect of implementation of the WHO’s Multimodal Hand Hygiene Improvement Strategy among healthcare workers of a tertiary teaching hospital in a developing country.Methods. Hand hygiene compliance was assessed among healthcare workers, according to five defined moments for hand hygiene of the WHO, before and after implementation of the WHO’s Multimodal Hand Hygiene Improvement Strategy in fourteen wards of a tertiary teaching hospital in Shiraz, Iran. We used direct observation method and documented the results in WHO hand hygiene observation forms.Results. There was a significant change in compliance before and after implementation of WHO’s Multimodal HH Improvement Strategy (29.8% and 70.98%, resp.).Conclusions. Implementing WHO hand hygiene program can significantly improve hand hygiene compliance among nurses.

Cluster Randomized Trial to Evaluate the Effect of a Multimodal Hand Hygiene Improvement Strategy in Primary Care

2012 ◽  
Vol 33 (7) ◽  
pp. 681-688 ◽  
Author(s):  
Carmen Martín-Madrazo ◽  
Sonia Soto-Díaz ◽  
Asuncion Cañada-Dorado ◽  
Miguel Angel Salinero-Fort ◽  
Manuela Medina-Fernández ◽  
...  
Keyword(s):  
Primary Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Cluster Randomized Trial ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Compliance Level ◽  
Hygiene Compliance ◽  
Cluster Randomized

Objective.To evaluate the effectiveness of a multimodal intervention in primary care health professionals for improved compliance with hand hygiene practice, based on the World Health Organization's 5 Moments for Health Hygiene.Design.Cluster randomized trial, parallel 2-group study (intervention and control).Setting.Primary healthcare centers in Madrid, Spain.Participants.Eleven healthcare centers with 198 healthcare workers (general practitioners, nurses, pediatricians, auxiliary nurses, midwives, odontostomatologists, and dental hygienists).Methods.The multimodal hand hygiene improvement strategy consisted of training of healthcare workers by teaching sessions, implementation of hydroalcoholic solutions, and installation of reminder posters. The hand hygiene compliance level was evaluated by observation during regular care activities in the office visit setting, at the baseline moment, and 6 months after the intervention, all by a single external observer.Results.The overall baseline compliance level was 8.1% (95% confidence interval [CI], 6.2-10.1), and the healthcare workers of the intervention group increased their hand hygiene compliance level by 21.6% (95% CI, 13.83-28.48) compared with the control group.Conclusions.This study has demonstrated that hand hygiene compliance in primary healthcare workers can be improved with a multimodal hand hygiene improvement strategy.

scholarly journals IMPLEMENTATION OF WHO HAND HYGIENE IMPROVEMENT STRATEGY IN TRNAVA UNIVERSITY HOSPITAL, SLOVAKIA

10.23856/3710 ◽  
2020 ◽  
Vol 37 (6) ◽  
pp. 99-106
Author(s):  
Janka Prnová ◽  
Jaroslava Brňová ◽  
Viera Rusnáková
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Daily Basis ◽  
University Hospital ◽  
World Health ◽  
Improvement Strategy ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Hygiene Compliance ◽  
The Impact

Hand hygiene is considered to be the most simple, effective and economic measure to prevent the spread of healthcare-associated infections and antimicrobial resistance. Based on the study, application of the World Health Organization’s Multimodal Hand Hygiene Improvement Strategy can improve hand hygiene compliance in hospital settings and reduce these infections. Trnava University Hospital was included to World Health Organization (WHO) launched a worldwide campaign focused on hand hygiene in 2013, when infection control specialist has started working on daily basis. Our objective was to evaluate the impact of implementing the Multimodal Hand Hygiene Strategy according to WHO. We assessed alcohol-based hand rub consumption during the period 2013 and 2018 and hand hygiene compliance in 2018 as a baseline. During observed period alcohol-based hand rub consumptions significantly increased from 15.7 L/1000 patient days to 24.3 L/1000 patient days (p<0.05). Overall compliance as per WHO guidelines were 38.9%.

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