“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

2021 ◽  
pp. 1-5
Author(s):  
Paritosh Prasad ◽  
Lynne Brown ◽  
Shiyang Ma ◽  
Andrew McDavid ◽  
Andrew Rudmann ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Fold Increase ◽  
Credible Interval ◽  
Clostridioides Difficile ◽  
Before And After ◽  
Clostridioides Difficile Infection ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
Hospital Acquired

Abstract Objective: To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. Design: We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. Settings: The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. Patients: All adult inpatients with the exception of patients in the obstetrics unit. Interventions: A hospital-wide universal gloving protocol was initiated on January 1, 2016. Results: Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12–1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). Conclusion: A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

scholarly journals Impact of Replacing Powdered Gloves With Powder-free Gloves on Hand-hygiene Compliance Among Healthcare Workers of an Intensive Care Unit: a Quasi-experimental Study

2020 ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Fernando Bellissimo-Rodrigues ◽  
Marcia A. Ciol ◽  
Maria Auxiliadora-Martins ◽  
Anibal Basile-Filho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Experimental Study ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Latex Gloves ◽  
Before And After ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
Powdered Latex Gloves

Abstract Background/Objective. After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). Methods. A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization (WHO) Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention.Results. Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% Confidence Interval [CI]: 51-59%) using powdered latex gloves and 60% (95% CI: 57-63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI: 2.5-7.6%, p<0.001).Conclusion. Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

scholarly journals Impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among healthcare workers of an intensive care unit: a quasi-experimental study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Fernando Bellissimo-Rodrigues ◽  
Marcia A. Ciol ◽  
Maria Auxiliadora-Martins ◽  
Anibal Basile-Filho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Experimental Study ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Latex Gloves ◽  
Before And After ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
Powdered Latex Gloves

Abstract Background/objective After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). Methods A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention. Results Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% confidence interval [CI] 51–59%) using powdered latex gloves and 60% (95% CI 57–63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI 2.5–7.6%, p < 0.001). Conclusion Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

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

scholarly journals Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study

2014 ◽  
Vol 100 (5) ◽  
pp. 454-459 ◽  
Author(s):  
Indah K Murni ◽  
Trevor Duke ◽  
Sharon Kinney ◽  
Andrew J Daley ◽  
Yati Soenarto
Keyword(s):  
Developing Countries ◽  
Hand Hygiene ◽  
Infection Control ◽  
Antibiotic Stewardship ◽  
Hand Hygiene Compliance ◽  
Antibiotic Use ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Rational Use Of Antibiotics ◽  
Hospital Acquired

BackgroundPrevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries.AimsTo implement a multifaceted infection control and antibiotic stewardship programme and evaluate its effectiveness on HAIs and antibiotic use.MethodsA before-and-after study was conducted over 27 months in a teaching hospital in Indonesia. All children admitted to the paediatric intensive care unit and paediatric wards were observed daily. Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of a hand hygiene campaign, antibiotic stewardship (using the WHO Pocket Book of Hospital Care for Children guidelines as standards of antibiotic prescribing for community-acquired infections), and other elementary infection control practices. Data were collected using an identical method in the preintervention and postintervention periods.ResultsWe observed a major reduction in HAIs, from 22.6% (277/1227 patients) in the preintervention period to 8.6% (123/1419 patients) in the postintervention period (relative risk (RR) (95% CI) 0.38 (0.31 to 0.46)). Inappropriate antibiotic use declined from 43% (336 of 780 patients who were prescribed antibiotics) to 20.6% (182 of 882 patients) (RR 0.46 (0.40 to 0.55)). Hand hygiene compliance increased from 18.9% (319/1690) to 62.9% (1125/1789) (RR 3.33 (2.99 to 3.70)). In-hospital mortality decreased from 10.4% (127/1227) to 8% (114/1419) (RR 0.78 (0.61 to 0.97)).ConclusionsMultifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised children in developing countries.

scholarly journals Improving children’s and their visitors’ hand hygiene compliance

2019 ◽  
Vol 21 (2) ◽  
pp. 60-67 ◽  
Author(s):  
Dina Lary ◽  
Aaron Calvert ◽  
Brigitte Nerlich ◽  
Joel Segal ◽  
Natalie Vaughan ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Qualitative Data ◽  
Educational Interventions ◽  
Structured Interviews ◽  
Randomised Study ◽  
Cluster Randomised ◽  
Before And After ◽  
Hygiene Compliance

Background: Numerous interventions have tried to improve healthcare workers’ hand hygiene compliance. However, little attention has been paid to children’s and their visitors’ compliance. Aim: To test whether interactive educational interventions increase children’s and visitors’ compliance with hand hygiene. Methods: This was a cluster randomised study of hand hygiene compliance before and after the introduction of educational interventions. Observations were compared for different moments of hygiene and times of the day. Qualitative data in the form of questionnaire-based structured interviews were obtained. Findings: Hand hygiene compliance increased by 24.4% ( P < 0.001) following the educational interventions, with children’s compliance reaching 40.8% and visitors’ being 50.8%. Compliance varied depending on which of the five moments of hygiene was observed ( P < 0.001), with the highest compliance being ‘after body fluid exposure’ (72.7%). Responses from questionnaires showed educational interventions raised awareness of the importance of hand hygiene (69%, 57%) compared to those who had not experienced the educational intervention (50%). Conclusion: Educational interventions may result in a significant increase in children’s and visitors’ hand hygiene ( P < 0.001).

Has Improved Hand Hygiene Compliance Reduced the Risk of Hospital-Acquired Infections among Hospitalized Patients in Ontario? Analysis of Publicly Reported Patient Safety Data from 2008 to 2011

2013 ◽  
Vol 34 (6) ◽  
pp. 605-610 ◽  
Author(s):  
Giulio DiDiodato
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Acute Care ◽  
Poisson Regression ◽  
Hand Hygiene Compliance ◽  
Acute Care Hospitals ◽  
Ordinary Least Squares ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

Design.Prospective, observational, ecological, time series, cross-sectional study examining the association between hand hygiene compliance (HHC) rates and the incidence of hospital-acquired infections.Setting.Acute care hospitals (N = 166) located in the province of Ontario, Canada.Methods.All data were extracted from the Ontario patient safety indicator database (http://www.hqontario.ca/public-reporting/patient-safety). Complete data were available for 166 acute care hospitals from October 1, 2008, to December 31, 2011. The rates of Clostridium difficile infection (CDI) are reported monthly, methicillin-resistant Staphylococcus aureus (MRSA) bacteremia quarterly, and HHC rates yearly. Trends and associations for each indicator were evaluated by ordinary least squares regression (HHC), zero-inflated Poisson regression (MRSA bacteremia), or Poisson regression (CDI). Dependent variables included in the regression analyses were extracted from the same database and included year, healthcare region, and type of hospital (teaching or small or large community).Results.Compared to those in 2008, reported HHC rates improved every year both before and after environment/patient contact (range, 10.6%–25.3%). Compared to those in 2008, there was no corresponding change in the rates of MRSA bacteremia; however, the rates of CDI decreased in 2009 but were not statistically significantly decreased from baseline in either 2010 or 2011. No consistent association was demonstrated between changes in the rates of HHC and these two healthcare-associated infections (HAIs).Conclusions.Despite significant improvements in reported rates of HHC among healthcare personnel in Ontario's hospitals, we could not demonstrate a positive ecological impact on rates of these two HAIs.

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