1189. Effectiveness of Multimodal Intervention Strategies to Improve Hand Hygiene Compliance at an Academic Medical Center

Abstract Background Since the early 19th century, hand hygiene (HH) has been recognized as the most important factor in preventing healthcare-associated infections (HAI). Still, improving HH compliance is a major hurdle for most healthcare facilities. Our study objective was to evaluate effectiveness of bundled intervention tools in increasing hand hygiene (HH) compliance. Methods The study was performed at the University of Mississippi Medical Center located in Jackson, MS. A multidisciplinary HH team was established in January 2016. Team members included infection prevention, nurse managers, physician, resident, housekeeping, process engineers, and ancillary staff. Hand hygiene compliance was determined based on room entry and exit observations. Intervention strategies were based on Joint Commission Center’s Targeted Solutions Tool (TST) to identify barriers in HH compliance, standardization of data collection, covert observer training and Just-in-time training of providers. Other strategies implemented included education and feedback, rewards and recognition, and system change measures during the 3-year study period (timeline in Table 1). Hand hygiene compliance was calculated based on number of compliance opportunities/total number of observations. One-way Analysis of Variance (ANOVA) was performed to analyze HH data. We did not assess the concomitant reduction in HAI rates as simultaneous HAI prevention strategies confounded analysis. Results Based on total 95,491 observations performed (January 2016- December 2018), there was a statistically significant improvement in HH compliance during the study period from 66.5% in 2016 to 73% in 2017 and 79.5% in 2018 (P = 0.04). Conclusion At our institution, we observed a 56% improvement in hand hygiene compliance over 36-months timeframe. Multidisciplinary team involvement and multimodal intervention strategies play crucial role in improvement and sustainment of HH compliance. Disclosures All authors: No reported disclosures.

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A multimodal intervention to improve hand hygiene compliance via social cognitive influences among kindergarten teachers in China

PLoS ONE ◽

10.1371/journal.pone.0215824 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0215824 ◽

Cited By ~ 1

Author(s):

Xiaona Liu ◽

Zhiguang Zhao ◽

Wanli Hou ◽

Suzanne Polinder ◽

Ed F. van Beeck ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Social Cognitive ◽

Kindergarten Teachers ◽

Improve Hand Hygiene ◽

Multimodal Intervention ◽

Cognitive Influences ◽

Hygiene Compliance

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Multimodal intervention program to improve hand hygiene compliance: effectiveness and challenges

Journal of Egyptian Public Health Association ◽

10.1186/s42506-020-00039-w ◽

2020 ◽

Vol 95 (1) ◽

Author(s):

Sihem Ben Fredj ◽

Asma Ben Cheikh ◽

Sana Bhiri ◽

Hela Ghali ◽

Salwa Khefacha ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Intervention Program ◽

Improve Hand Hygiene ◽

Multimodal Intervention ◽

Hygiene Compliance

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A multimodal intervention to improve hand hygiene compliance in a tertiary care center

American Journal of Infection Control ◽

10.1016/j.ajic.2017.12.017 ◽

2018 ◽

Vol 46 (7) ◽

pp. 775-780 ◽

Cited By ~ 6

Author(s):

Abdul Mannan Laskar ◽

Deepashree R ◽

Prasanna Bhat ◽

Biju Pottakkat ◽

Sunil Narayan ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Improve Hand Hygiene ◽

Multimodal Intervention ◽

Hygiene Compliance

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A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv121 ◽

2015 ◽

Vol 2 (4) ◽

Cited By ~ 16

Author(s):

Richard T. Ellison ◽

Constance M. Barysauskas ◽

Elke A. Rundensteiner ◽

Di Wang ◽

Bruce Barton

Keyword(s):

Hand Hygiene ◽

Real Time ◽

Healthcare Workers ◽

Medical Center ◽

Controlled Trial ◽

Academic Medical Center ◽

Controlled Clinical Trial ◽

Improve Hand Hygiene ◽

Reminder System ◽

Hygiene Compliance

Abstract Background. The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods. A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results. In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P < .001); in addition, the ratio of hand hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P < .001). The performance returned to baseline (1473 hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions. In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity.

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

Behavioural Public Policy ◽

10.1017/bpp.2021.15 ◽

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.

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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1130 ◽

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

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Interventions to improve hand hygiene compliance in patient care

10.1002/14651858.cd005186 ◽

2004 ◽

Cited By ~ 2

Author(s):

JH Chudleigh ◽

DJ Gould ◽

R Grol ◽

D Moralejo

Keyword(s):

Hand Hygiene ◽

Patient Care ◽

Hand Hygiene Compliance ◽

Improve Hand Hygiene ◽

Hygiene Compliance

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Description of Hand Hygiene’s Compliance on Nurse of Hemodialysis at Haji Hospital Surabaya

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v5i22017.240-252 ◽

2017 ◽

Vol 5 (2) ◽

pp. 240

Author(s):

Rr Rizqi Saphira Nurani ◽

Atik Choirul Hidajah

Keyword(s):

Hand Hygiene ◽

General Hospital ◽

Hand Hygiene Compliance ◽

Health Workers ◽

Data Retrieval ◽

Improve Hand Hygiene ◽

Descriptive Research ◽

Hemodialysis Unit ◽

Audit Form ◽

Hygiene Compliance

Thousands patients around the world die every day because of infections when they get treatment. This is because the transmission of microbacteria from the hands of health workers. Hand hygiene is the most important aspect to prevent the transmission of microbacteria and preventing HAIs. Hand hygiene awareness of health workers is a fundamental behavior to prevent cross-infection. The purpose of this study was to evaluate the hand hygiene compliance of nurse in Unit Hemodialysis of Hajj General Hospital Surabaya. Type of this research is descriptive research and observations by using a qualitative approach. Data retrieval on the research is an interview with nurse and audit hand hygiene. Research instrument using a questionnaire of hand hygiene and BSI knowledge, and hand hygiene audit form made by WHO. The population in this research was all nurses in Hemodialysis Unit General Hospital Surabaya Hajj that add up to 11 people. The results of this research obtained that compliance with hand hygiene Unit Hemodialysis nurse is 35%. The compliance were still less and has not reached the standards established by the PPI Hajj General Hospital Surabaya that is 100% and still has not reach compliance standards of WHO that is 40%. Hand hygiene compliance was low caused by the low participation of PPI base training and the lack of availability of hand hygiene facility in the Hemodialysis Unit General Hospital Surabaya Hajj. Advice from research were conducting on job training about how to perform hand hygiene and improve hand hygiene facilities in Hemodialysis Units. Keywords: hand hygiene, compliance, nurse

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Incubator traffic light: the development of an alcohol-based hand rub dispenser system for neonatal incubators with visual feedback to improve hand hygiene compliance

BMJ Innovations ◽

10.1136/bmjinnov-2018-000301 ◽

2019 ◽

Vol 5 (2-3) ◽

pp. 70-77

Author(s):

Ronald H J van Gils ◽

Onno K Helder ◽

Linda S G L Wauben

Keyword(s):

Hand Hygiene ◽

Behaviour Change ◽

Visual Feedback ◽

Hand Hygiene Compliance ◽

Healthcare Professionals ◽

Bloodstream Infections ◽

Traffic Light ◽

Improve Hand Hygiene ◽

Drying Time ◽

Hygiene Compliance

IntroductionSustained high compliance with hand hygiene prior to patient contact in a neonatal intensive care unit (NICU) could reduce the spread of pathogens and incidence of bloodstream infections of preterm infants. These infections are associated with high mortality, morbidity and additional costs. Behaviour change interventions to promote hand hygiene, such as education, have only temporary beneficial effect on compliance. Our aim is to develop a technical intervention that supports a sustainable behaviour change for appropriate hand hygiene among NICU healthcare professionals.MethodsStudents from different disciplines incrementally designed and evaluated solutions in co-creation with healthcare professionals of a NICU in a teaching hospital.ResultsA prototype of the ‘Incubator Traffic Light’ system for neonatal incubators was developed, that is, a touchless alcohol-based hand rub (ABHR) dispenser with integrated colour display and incubator door sensor with lights. The system provides visual feedback to support healthcare professionals’ compliance with the prescribed 30 s drying time for ABHR. After 30 s, green lights indicate that the incubator doors may be opened. In the event that doors are opened without dispensing ABHR or earlier than 30 s, blinking orange lights and a display message urge the person to close the doors. The system documents compliance data in a web-based database.ConclusionsWe developed a sophisticated technical intervention to support hand hygiene compliance. It is ready for clinical tests that should prove that the system contributes to sustainable hand hygiene compliance near neonatal incubators.

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