Multi-Facility Reduction in Hospital-Acquired Infections (HAIs) Through Real-Time Feedback and Individual Accountability

Background: Hospital-acquired infections (HAIs) are a leading cause of healthcare morbidity and cost for the health community. It is widely recognized that hand hygiene is the leading contributor infections, but hand hygiene still remains a major problem for nearly all healthcare systems. A longitudinal study was conducted over a 4-year period in a community-based health system. Methods: An electronic hand hygiene reminder system was installed in 2 different facilities including both critical care and noncritical units. This system collects data on individual healthcare provider hand hygiene and provides a real-time voice reminder in the event that a provider forgets to perform hand hygiene. The primary study was designed to investigate the impact of a real-time voice reminder to improve hand hygiene. A baseline period of hand hygiene was established prior to the interventions after installing the system without any access to data reporting or the voice reminder. Each of the hospitals had the voice reminder turned on and off 3 times. The baseline HAI rates were established by comparing in each facility for the 12 months prior to the implementation of the system. During the study period, there were no significant changes to other common infection control practices. Results: In both facilities, every time the voices were turned on, hand hygiene improved significantly and each clinical unit saw a >200% improvement in hand hygiene within 3 months of turning the voice reminder. HAIs fell by a statistically significant in all clinical areas by 51%. After a period of stabilization, the voice reminder was turned off hand hygiene compliance fell and HAI rates then increased. The voice reminder was then turned back on and off 2 more times. In every case, hand hygiene rates fell back to the baseline and HAIs returned to their baseline. When the voice reminder was then turned back on, HAIs dropped to 54%–81% of the baseline in each of the clinical units. The system also captured individual providers’ hand hygiene performance data and displayed it in a simple and engaging way, allowing managers easily understand who was struggling with hand hygiene. These data were then leveraged through a series of competitions to systematically drive hand hygiene performance improvement. These included traditional interventions to address an education issue in addition to interventions to identify workflow problems. Conclusions: Using this highly targeted approach, the leadership were able to efficiently drive sustained hand hygiene improvement and a further reduction in HAIs.Funding: NoneDisclosures: None

Download Full-text

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

Polonia University Scientific Journal ◽

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%.

Download Full-text

The impact of universal face masking and enhanced hand hygiene for COVID-19 disease prevention on the incidence of hospital acquired infections in a Taiwanese hospital

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.12.072 ◽

2020 ◽

Author(s):

Shih-Hao Lo ◽

Chun-Yu Lin ◽

Ching-Tzu Hung ◽

Jyun-Ji He ◽

Po-Liang Lu

Keyword(s):

Disease Prevention ◽

Hand Hygiene ◽

Hospital Acquired Infections ◽

Hospital Acquired ◽

The Impact

Download Full-text

Correlation between Antibiotic Consumption and Hand Hygiene Compliance Among Anesthesia and Intensive Care Healthcare Professionals

The Open Anesthesia Journal ◽

10.2174/2589645802014010042 ◽

2020 ◽

Vol 14 (1) ◽

pp. 42-48

Author(s):

Emanuela Santoro ◽

Marco Fiore ◽

Sebastiano Leone ◽

Armando Masucci ◽

Roberta Manente ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Healthcare Professionals ◽

Tertiary Care ◽

Antibiotic Consumption ◽

Alcoholic Solution ◽

Hand Washing ◽

Hospital Acquired Infections ◽

Consumption Data ◽

Hospital Acquired

Aims: The aim of this study was to investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals working in the Department of Anesthesia and Intensive Care of a tertiary care University Hospital. Background: Two centuries have passed since the discovery of Semmelweis that the “puerperal fever” was due to an infection transmitted by the hands. Currently the hand hygiene is still not well performed, rather it is often replaced by the improper use of gloves. Microbial transmission is estimated to occur in one-fifth of all contact cases. Objective: To investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals. Furthermore, to correlate the consumption data of the hydroalcoholic solution and the amount of antibiotics used for the treatment of hospital-acquired infections. Method: The study was conducted over six months period (from January to June 2018); during this period, 20 monitoring sessions were performed. The following indicators were evaluated: a) Non-adherence to hand hygiene with concomitant use of gloves; b) Adhesion to alcoholic friction of hands; c) Hand-washing adhesion. Instead, the consumption data, provided by the hospital ward itself, were used for the evaluation of d) The antibiotics used in the treatment of hospital-acquired infections; e) The hydro-alcoholic solution used by the healthcare professionals for hand hygiene. Results: The frequency of non-adherence to hand hygiene was very high at the beginning of the study, subsequently it decreased to about a half percent to that at the initial stage. The adhesion to alcoholic friction of hands increased during the study period. Otherwise, the hand-washing adhesion slightly reduced, especially in March probably due to the recruitment of new inadequately trained nursing staff. The trend of antibiotic consumption was similar to handwashing. The consumption of hydro-alcoholic solution was very low, however over time, it increased considerably until the end of the study. Conclusion: In light of the findings from this work, it is necessary to make the hospital staff increasingly aware of the correct practice of hand hygiene and to organize training and informative sessions to promote the health of the individual and the community.

Download Full-text

A mHealth intervention to promote hand-washing and cell phone cleaning in medical residents of a public hospital in Peru

The Journal of Infection in Developing Countries ◽

10.3855/jidc.13382 ◽

2021 ◽

Vol 15 (03) ◽

pp. 428-435

Author(s):

Maria Lazo-Porras ◽

Matilde Corante ◽

Tania De La Cruz-Saldaña ◽

Ingrid Bohórquez ◽

Kalina Campos ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Hand Hygiene ◽

Cell Phones ◽

Bacterial Colonization ◽

Hand Washing ◽

Medical Residents ◽

Chi Square ◽

Mhealth Intervention ◽

Hospital Acquired ◽

The Impact

Introduction: We explore the limitations to adherence of hand-washing and evaluate the impact of a mHealth intervention for hand hygiene in residents. Methodology: We explore resident's perspectives about Hospital-acquired infections (HAI) and hand washing. In baseline, participants completed socio-demographic characteristics and hand-washing habits survey. The intervention consisted of sending SMS three times a week for two months about hand hygiene and “five moments” for hand washing. The cultures of hands and cell phones were analyzed at baseline, 2 months and 4 months. We used chi-square and adjusted Generalized Estimating Equations. Results: Five physicians were interviewed and 33 participants were included for quantitative analysis. Critical barriers that hinder hand washing were identified. The proportion of Staphylococcus aureus in hands was 54.5% at baseline and was significantly reduced at 2 months follow-up (p = 0.009), but, benefit was lost when the intervention was discontinued; Escherichia coli and Klebsiella sp. were observed in 22.2% of hands, no changes were noted with intervention. In cell phones, there was a tendency to lower values of bacterial colonization after intervention for Staphylococcus aureus growth. Conclusions: High prevalence of contamination in hands and phones in medical residents were found. Serious barriers to compliance with hand washing must be overcome. It is possible that prolonged or continuous interventions could be necessary to optimize hand washing and reduce hand and cell phones contamination.

Download Full-text

O083: Prohibit (preventing hospital-acquired infections by intervention and training): preliminary results of a European multi-center study on the effectiveness of a hand hygiene campaign and a central venous catheter bundle

Antimicrobial Resistance and Infection Control ◽

10.1186/2047-2994-2-s1-o83 ◽

2013 ◽

Vol 2 (S1) ◽

Cited By ~ 1

Author(s):

T van der Kooi ◽

◽

M Wolkewitz ◽

B van Benthem ◽

S de Greeff ◽

...

Keyword(s):

Central Venous Catheter ◽

Hand Hygiene ◽

Venous Catheter ◽

Central Venous ◽

Hospital Acquired Infections ◽

Hand Hygiene Campaign ◽

Multi Center Study ◽

Hospital Acquired ◽

And Training ◽

Center Study

Download Full-text

Highly sensitive detection of Staphylococcus aureus by a THz metamaterial biosensor based on gold nanoparticles and rolling circle amplification

RSC Advances ◽

10.1039/d0ra03116j ◽

2020 ◽

Vol 10 (45) ◽

pp. 26824-26833 ◽

Cited By ~ 2

Author(s):

Ke Yang ◽

Wenjing Yu ◽

Guorong Huang ◽

Jie Zhou ◽

Xiang Yang ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Rolling Circle Amplification ◽

Rolling Circle ◽

Hospital Acquired Infections ◽

Food Borne ◽

Highly Sensitive ◽

Food Borne Illness ◽

Highly Sensitive Detection ◽

Hospital Acquired ◽

The Impact

A highly sensitive method for detecting Staphylococcus aureus (S. aureus) is urgently needed to reduce the impact and spread of hospital-acquired infections and food-borne illness.

Download Full-text

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

Infection Control and Hospital Epidemiology ◽

10.1086/656592 ◽

2010 ◽

Vol 31 (11) ◽

pp. 1170-1176 ◽

Cited By ~ 33

Author(s):

Dominik Mertz ◽

Nancy Dafoe ◽

Stephen D. Walter ◽

Kevin Brazil ◽

Mark Loeb

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Tertiary Care ◽

Intervention Group ◽

Multifaceted Intervention ◽

Cluster Randomized ◽

Hospital Acquired ◽

Tertiary Care Hospitals ◽

The Impact ◽

Mrsa Colonization

Objectives.Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization.Design.Cluster-randomized controlled trial.Setting.Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada.Intervention.After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008.Results.We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group.Conclusion.Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

Download Full-text

Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol

BMJ Open ◽

10.1136/bmjopen-2017-017108 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017108 ◽

Cited By ~ 5

Author(s):

Kelly Ann Schmidtke ◽

Navneet Aujla ◽

Tom Marshall ◽

Abid Hussain ◽

Gerard P Hodgkinson ◽

...

Keyword(s):

Hand Hygiene ◽

Research Ethics ◽

Total Duration ◽

Well Being ◽

Hospital Acquired Infections ◽

South Central ◽

Priming Condition ◽

Registration Number ◽

Hygiene Compliance ◽

Hospital Acquired

IntroductionCompliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients’ well-being and hospitals’ finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study.Methods and analysisThe study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards.Ethics and disseminationResearch ethics approval was obtained from the South Central—Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor.Trial registration numberISRCTN (15397624); Edge ID 86357.

Download Full-text