Controlled Trial Measuring the Effect of a Feedback Intervention on Hand Hygiene Compliance in a Step-Down Unit

2008 ◽  
Vol 29 (8) ◽  
pp. 730-735 ◽  
Author(s):  
Alexandre R. Marra ◽  
Cláudia D'Arco ◽  
Bruno de Arruda Bravim ◽  
Marinês Dalla Valle Martino ◽  
Luci Correa ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Controlled Trial ◽  
Control Unit ◽  
Feedback Intervention ◽  
Control Units ◽  
Hygiene Compliance ◽  
And Control ◽  
Intervention Unit

Objective.To evaluate hand hygiene compliance in 2 adult step-down units (SDUs).Design.A 6-month (from March to September 2007), controlled trial comparing 2 SDUs, one with a feedback intervention program (ie, the intervention unit) and one without (ie, the control unit).Setting.Two 20-bed SDUs at a tertiary care private hospital.Methods.Hand hygiene episodes were measured by electronic recording devices and periodic observational surveys. In the intervention unit, feedback was provided by the SDU nurse manager, who explained twice a week to the healthcare workers the goals and targets for the process measures.Results.A total of 117,579 hand hygiene episodes were recorded in the intervention unit, and a total of 110,718 were recorded in the control unit (P= .63). There was no significant difference in the amount of chlorhexidine used in the intervention and control units (34.0 vs 26.7 L per 1,000 patient-days;P= .36) or the amount of alcohol gel used (72.5 vs 70.7 L per 1,000 patient-days;P= .93). However, in both units, healthcare workers used alcohol gel more frequently than chlorhexidine (143.2 vs 60.7 L per 1,000 patient-days;P< .001). Nosocomial infection rates in the intervention and control units, respectively, were as follows: for bloodstream infection, 3.5 and 0.79 infections per 1,000 catheter-days (P= .18); for urinary tract infection, 15.8 and 15.7 infections per 1,000 catheter-days (P= .99); and for tracheostomy-associated pneumonia, 10.7 and 5.1 infections per 1,000 device-days (P= . 13). There were no cases of infection with vancomycin-resistant enterococci and only a single case of infection with methicillin-resistantStaphylococcus aureus(in the control unit).Conclusions.The feedback intervention regarding hand hygiene had no significant effect on the rate of compliance. Other measures must be used to increase and sustain the rate of hand hygiene compliance.

scholarly journals Dissemination interventions to improve healthcare workers’ adherence with infection prevention and control guidelines: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marcus Tolentino Silva ◽  
Tais Freire Galvao ◽  
Evelina Chapman ◽  
Everton Nunes da Silva ◽  
Jorge Otávio Maia Barreto
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Infection Prevention ◽  
Meta Analysis ◽  
Infection Prevention And Control ◽  
Vaccination Uptake ◽  
Hygiene Compliance ◽  
And Control

Abstract Background The COVID-19 pandemic has challenged health systems worldwide since 2020. At the frontline of the pandemic, healthcare workers are at high risk of exposure. Compliance with infection prevention and control (IPC) should be encouraged at the frontline. This systematic review aimed to assess the effects of dissemination interventions to improve healthcare workers’ adherence with IPC guidelines for respiratory infectious diseases in the workplace. Methods We searched CENTRAL, MEDLINE, Embase, and the Cochrane COVID-19 Study Register. We included randomized controlled trials (RCTs) and cluster RCTs that assessed the effect of any dissemination strategy in any healthcare settings. Certainty of evidence was assessed using the GRADE approach. We synthesized data using random-effects model meta-analysis in Stata 14.2. Results We identified 14 RCTs conducted from 2004 to 2020 with over 65,370 healthcare workers. Adherence to IPC guidelines was assessed by influenza vaccination uptake, hand hygiene compliance, and knowledge on IPC. The most assessed intervention was educational material in combined strategies (plus educational meetings, local opinion leaders, audit and feedback, reminders, tailored interventions, monitoring the performance of the delivery of health care, educational games, and/or patient-mediated interventions). Combined dissemination strategies compared to usual routine improve vaccination uptake (risk ratio [RR] 1.59, 95% confidence interval [CI] 1.54 to 1.81, moderate-certainty evidence), and may improve hand hygiene compliance (RR 1.70; 95% CI 1.03 to 2.83, moderate-certainty). When compared to single strategies, combined dissemination strategies probably had no effect on vaccination uptake (RR 1.01, 95% CI 0.95 to 1.07, low-certainty), and hand hygiene compliance (RR 1.16, 95% CI 0.99 to 1.36, low-certainty). Knowledge of healthcare workers on IPC improved when combined dissemination strategies were compared with usual activities, and the effect was uncertain in comparison to single strategy (very low-certainty evidence). Conclusions Combined dissemination strategies increased workers’ vaccination uptake, hand hygiene compliance, and knowledge on IPC in comparison to usual activities. The effect was negligible when compared to single dissemination strategies. The adoption of dissemination strategies in a planned and targeted way for healthcare workers may increase adherence to IPC guidelines and thus prevent dissemination of infectious disease in the workplace. Trial registration Protocol available at http://osf.io/aqxnp.

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 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 Hand hygiene compliance in the intensive care unit of the Onderstepoort Veterinary Academic Hospital.

2019 ◽  
Author(s):  
Dikeledi Carol Sebola ◽  
Charlie Boucher ◽  
Caroline Maslo ◽  
Daniel Nenene Qekwana
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Infection Prevention And Control ◽  
Patient Contact ◽  
Academic Hospital ◽  
Hand Wash ◽  
Hygiene Compliance

Abstract Hand hygiene compliance remains the cornerstone of infection prevention and control (IPC) in healthcare facilities. However, there is a paucity of information on the level of IPC in veterinary health care facilities in South Africa. Therefore, this study evaluated hand hygiene compliance of healthcare workers and visitors in the intensive care unit (ICU) at the Onderstepoort Veterinary Academic Hospital (OVAH). Method: A cross-sectional study was conducted among healthcare workers (HCWs) and visitors in the ICU using the infection control assessment tool (ICAT) as stipulated by the South African National Department of Health. Direct observations using the “five hand hygiene moments” criteria as set out by the World helath Organisation were also recorded. The level of compliance and a 95% confidence interval were calculated for all variables. Results: Individual bottles of alcohol-based hand-rub solution and hand-wash basins with running water, soap dispensers, and paper towels were easily accessible and available at all times in the ICU. In total, 296 observations consisting of 734 hand hygiene opportunities were recorded. Hand hygiene compliance was also evaluated during invasive (51.4%) and non-invasive (48.6%) procedures. The overall hand hygiene compliance was 24.3% (178/734). In between patients, most HCWs did not sanitize stethoscopes, leashes, and cellular phones used. Additionally, the majority of HCWs wore jewellery below the elbows. The most common method of hand hygiene was hand-rub (58.4%), followed by hand-wash (41.6%). Nurses had a higher (44%) level of compliance compared to students (22%) and clinicians (15%). Compliance was also higher after body fluid exposure (42%) compared to after patient contact (32%), before patient contact (19%), after contact with patient surroundings (16%), and before an aseptic procedure (15%). Conclusion: Hand hygiene compliance in this study was low, raising concerns of potential transmission of hospital-acquired infections and zoonoses in the ICU. Therefore, it is essential that educational programs be developed to address the low level of hand hygiene in this study.

scholarly journals Improving Hand Hygiene Compliance in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial (HANDSOME Study)

10.2196/17419 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17419 ◽  
Author(s):  
Gwen R Teesing ◽  
Vicki Erasmus ◽  
Mariska Petrignani ◽  
Marion P G Koopmans ◽  
Miranda de Graaf ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Disease Incidence ◽  
Controlled Trial ◽  
World Health ◽  
The World ◽  
Hygiene Compliance ◽  
Cluster Randomized

Background Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care–associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods Nursing homes were randomly allocated to 1 of 3 trial arms: receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization’s 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing home environment. Nurses were taught the World Health Organization’s 5 moments of hand hygiene guidelines using the slogan “Room In, Room Out, Before Clean, After Dirty,” which was developed for nursing staff to better understand and remember the hygiene guidelines. HANDSOME should contribute to improved hand hygiene practice and a reduction in infectious disease rates and related mortality. Trial Registration Netherlands Trial Register (NTR6188) NL6049; https://www.trialregister.nl/trial/6049 International Registered Report Identifier (IRRID) DERR1-10.2196/17419

scholarly journals Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study

2020 ◽  
Vol 25 (5) ◽  
pp. 177-186
Author(s):  
Aaron Asibi Abuosi ◽  
Samuel Kaba Akoriyea ◽  
Gloria Ntow-Kummi ◽  
Joseph Akanuwe ◽  
Patience Aseweh Abor ◽  
...  
Keyword(s):  
Health Care ◽  
Observational Study ◽  
Hand Hygiene ◽  
Outcome Measures ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Job Aids ◽  
The Mean ◽  
Hygiene Compliance

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.

Role of a multimodal intervention to promote hand hygiene compliance among healthcare workers

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
V Baccolini ◽  
P de Soccio ◽  
V D'Egidio ◽  
G Migliara ◽  
C Marzuillo ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Multimodal Intervention ◽  
Hygiene Compliance
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