scholarly journals Intervening with healthcare workers’ hand hygiene compliance, knowledge, and perception in a limited-resource hospital in Indonesia: a randomized controlled trial study

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Dewi Santosaningsih ◽  
Dewi Erikawati ◽  
Sanarto Santoso ◽  
Noorhamdani Noorhamdani ◽  
Irene Ratridewi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Controlled Trial ◽  
Limited Resource ◽  
Randomized Controlled ◽  
Hygiene Compliance

scholarly journals Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

2020 ◽  
Vol 41 (10) ◽  
pp. 1169-1177
Author(s):  
Gwen R. Teesing ◽  
Vicki Erasmus ◽  
Daan Nieboer ◽  
Mariska Petrignani ◽  
Marion P.G Koopmans ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Controlled Trial ◽  
Multimodal Intervention ◽  
Randomized Controlled ◽  
Hygiene Compliance ◽  
Cluster Randomized

AbstractObjective:To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes.Design, setting, and participants:HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded.Intervention:Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty.Results:HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%).Conclusions:The HANDSOME intervention is successful in improving HHC in nursing homes.

scholarly journals A Crossover Randomized Controlled Trial of Priming Interventions to Increase Hand Hygiene at Ward Entrances

2022 ◽  
Vol 9 ◽  
Author(s):  
Kelly Ann Schmidtke ◽  
Navneet Aujla ◽  
Tom Marshall ◽  
Abid Hussain ◽  
Gerard P. Hodgkinson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Controlled Trial ◽  
The United States ◽  
Future Research ◽  
Randomized Controlled ◽  
The United Kingdom ◽  
Visual Priming ◽  
Hygiene Compliance

BackgroundResearch conducted in the United States suggests that two primes (citrus smells and pictures of a person's eyes) can increase hand gel dispenser use on the day they are introduced in hospital. The current study, conducted at a hospital in the United Kingdom, evaluated the effectiveness of these primes, both in isolation and in combination, at the entry way to four separate wards, over a longer duration than the previous work.MethodsA crossover randomized controlled trial was conducted. Four wards were allocated for 6 weeks of observation to each of four conditions, including “control,” “olfactory,” “visual,” or “both” (i.e., “olfactory” and “visual” combined). It was hypothesized that hand hygiene compliance would be greater in all priming conditions relative to the control condition. The primary outcome was whether people used the gel dispenser when they entered the wards. After the trial, a follow up survey of staff at the same hospital assessed the barriers to, and facilitators of, hand hygiene compliance. The trial data were analyzed using regression techniques and the survey data were analyzed using descriptive statistics.ResultsThe total number of individuals observed in the trial was 9,811 (female = 61%), with similar numbers across conditions, including “control” N = 2,582, “olfactory” N = 2,700, “visual” N = 2,488, and “both” N = 2,141. None of the priming conditions consistently increased hand hygiene. The lowest percentage compliance was observed in the “both” condition (7.8%), and the highest was observed in the “visual” condition (12.7%). The survey was completed by 97 staff (female = 81%). “Environmental resources” and “social influences” were the greatest barriers to staff cleaning their hands.ConclusionsTaken together, the current findings suggest that the olfactory and visual priming interventions investigated do not influence hand hygiene consistently. To increase the likelihood of such interventions succeeding, future research should focus on prospectively determined mechanisms of action.

scholarly journals Improving hand hygiene compliance in child daycare centres: a randomized controlled trial

2016 ◽  
Vol 144 (12) ◽  
pp. 2552-2560 ◽  
Author(s):  
T. P. ZOMER ◽  
V. ERASMUS ◽  
C. W. LOOMAN ◽  
E. F. VAN BEECK ◽  
A. TJON-A-TSIEN ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Respiratory Infections ◽  
Controlled Trial ◽  
Usual Practice ◽  
Randomized Controlled ◽  
Hygiene Compliance ◽  
Cluster Randomized ◽  
Child Daycare Centres

SUMMARYGastrointestinal and respiratory infections in children attending daycare centres (DCCs) are common and compliance with hand hygiene (HH) guidelines to prevent infections is generally low. An intervention was developed to increase HH compliance and reduce infections in DCCs. The objective of this paper was to evaluate the effectiveness of this intervention on HH compliance. The intervention was evaluated in a two-arm cluster randomized controlled trial in 71 DCCs in The Netherlands. Thirty-six DCCs received the intervention including: (1) HH products; (2) training about HH guidelines; (3) two team training sessions aimed at goal setting and formulating HH improvement activities; and (4) reminders and cues for action (posters/stickers). Intervention DCCs were compared to 35 control DCCs that continued usual practice. HH compliance of caregivers and children was observed at baseline and at 1, 3 and 6 months follow-up. Using multilevel logistic regression, odds ratios (ORs) with 95% confidence intervals (CIs) were obtained for the intervention effect. Of 795 caregivers, 5042 HH opportunities for caregivers and 5606 opportunities for supervising children's HH were observed. At 1 month follow-up caregivers' compliance in intervention DCCs was 66%vs.43% in control DCCs (OR 6·33, 95% CI 3·71–10·80), and at 6 months 59%vs.44% (OR 4·13, 95% CI 2·33–7·32). No effect of the intervention was found on supervising children's HH (36%vs.32%; OR 0·64, 95% CI 0·18–2·33). In conclusion, HH compliance of caregivers increased due to the intervention, therefore dissemination of the intervention can be considered.

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 Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Ephrem Tefera Solomon ◽  
Sirak Robele Gari ◽  
Helmut Kloos ◽  
Bezatu Mengistie Alemu
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Controlled Trial ◽  
Eastern Ethiopia ◽  
Randomized Controlled ◽  
Dire Dawa ◽  
Cluster Randomized ◽  
Diarrheal Incidence ◽  
Handwashing With Soap ◽  
Children Under 5

Abstract Background Handwashing with soap reduces diarrheal diseases burden considerably. However, the importance of handwashing in homes has received little attention in rural eastern Ethiopia. The effectiveness of handwashing may be reduced by lack of information on when and in what event hands must be washed, the frequency of handwashing, the individual who should wash his/her hands, and the procedure of handwashing. In these areas, indicators of adherence to handwashing are yet to be established. This study aimed at assessing the efficiency of handwashing on reducing diarrheal disease in children under 5 years old in rural kebeles of Dire Dawa, east Ethiopia. Methods Community-based cluster randomized controlled trial was conducted in rural kebeles of Dire Dawa for 4 months starting from October 2018 to January 2019. Selected clusters were randomized in intervention and control arms using draw method and data collectors conducted the baseline survey. Households assigned to the intervention group were given two bars of plain soap on a bi-monthly basis together with information promoting hand hygiene. Control households were allowed to continue their habitual handwashing practices. We compared the diarrheal incidences of the intervention and non-intervention households. Generalized estimation equations using Poisson family and log choice of the link was employed to calculate adjusted incidence rate ratio with its 95% confidence interval. Results We recorded a significant lesser diarrheal incidence in the handwashing arm than in the non-intervention arm (6.9 versus 13.8 episodes per 100 person weeks of observation). In all, there was a 41% reduction in diarrheal incidence in the intervention arm in relation to the non-intervention arm. Conclusion Handwashing with soap complemented with hand hygiene promotion significantly decreased diarrheal episodes in children under 5 years old in rural kebeles of Dire Dawa. We recommend the promotion and adaptation of washing hands using soap at recommended times to be an effective means of reducing childhood diarrhea morbidity in rural populations of Ethiopia towards achieving the Sustainable Development Goal 6. Trial registration PACTR, PACTR201807815961394. Registered 16 July 2018,

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 Impact of Xpert MTB/RIF on Antiretroviral Therapy-Associated Tuberculosis and Mortality: A Pragmatic Randomized Controlled Trial

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
L. Mupfumi ◽  
B. Makamure ◽  
M. Chirehwa ◽  
T. Sagonda ◽  
S. Zinyowera ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Limited Resource ◽  
Hiv Treatment ◽  
Treatment Programs ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Art Initiation

Abstract Introduction.  GeneXpert® MTB/RIF (Xpert) is now widely distributed in high human immunodeficiency virus (HIV)/tuberculosis (TB)-burden countries. Yet, whether the test improves patient-important outcomes within HIV treatment programs in limited resource settings is unknown. Methods.  To investigate whether use of Xpert for TB screening prior to initiation of antiretroviral treatment (ART) improves patient-important outcomes, in a pragmatic randomized controlled trial we assigned 424 patients to Xpert or fluorescence sputum smear microscopy (FM) at ART initiation. The primary endpoint was a composite of 3-month mortality and ART-associated TB. Results.  There was no difference in overall TB diagnosis at ART initiation (20% [n = 43] Xpert vs 21% [n = 45] FM; P = .80), with most patients in both groups treated empirically. There was no difference in time to TB treatment initiation {5 days (interquartile range [IQR], 3–13) vs 8 days [IQR, 3–23; P = .26]} or loss to follow-up (32 [15%] vs 38 [18%]; P = 0.38). Although a nonsignificant reduction in mortality occurred in the Xpert group (11 [6%] vs 17 [10%]; 95% CI, −9% to 2%; P = .19), there was no difference in the composite outcome (9% [n = 17] Xpert vs 12% [n = 21] FM; difference −3%; 95% CI, −9% to 4%). Conclusions.  Among HIV-infected initiating ART, centralized TB screening with Xpert did not reduce the rate of ART-associated TB and mortality, compared with fluorescence microscopy.

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

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