scholarly journals The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.

2020 ◽  
Author(s):  
Yumi Suzuki ◽  
Motoko Morino ◽  
Ichizo Morita ◽  
Shigenori Yamamoto

Abstract Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score.Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

2020 ◽  
Author(s):  
Yumi Suzuki ◽  
Motoko Morino ◽  
Ichizo Morita ◽  
Shigenori Yamamoto

Abstract Background:A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative consisting of the 5 Components, the 5 Steps, and the HH Self-Assessment Framework (HHSAF) was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and HHSAF score.Methods:The consumption of monthly hospital-wide ABHR was calculated as ml per patient day (PD). The change in ABHR consumption was analysed by an interrupted time series analysis, with a preintervention period of 36 months and an intervention period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results:A statistically significant increase was found in the monthly ABHR consumption (change in slope: + 0.479 ml/PD, p < 0.01). Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions:A 5-year, 5-step, WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF score can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.


2013 ◽  
Vol 2 (Suppl 1) ◽  
pp. P113
Author(s):  
AM Ribeiro ◽  
Francisca Nogueira Della Guardia ◽  
Virginia Ramos Sampaio ◽  
Rivânia Barros ◽  
Diana Maria da Silva ◽  
...  

PLoS Medicine ◽  
2020 ◽  
Vol 17 (11) ◽  
pp. e1003269
Author(s):  
David Pell ◽  
Tarra L. Penney ◽  
Oliver Mytton ◽  
Adam Briggs ◽  
Steven Cummins ◽  
...  

Background Sugar-sweetened beverage (SSB) consumption is positively associated with obesity, type 2 diabetes, and cardiovascular disease. The World Health Organization recommends that member states implement effective taxes on SSBs to reduce consumption. The United Kingdom Soft Drinks Industry Levy (SDIL) is a two-tiered tax, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g of sugar per 100 ml (higher levy tier) are taxed at £0.24 per litre, drinks with ≥5 to <8 g of sugar per 100 ml (lower levy tier) are taxed at £0.18 per litre, and drinks with <5 g sugar per 100 ml (no levy) are not taxed. Milk-based drinks, pure fruit juices, drinks sold as powder, and drinks with >1.2% alcohol by volume are exempt. We aimed to determine if the announcement of the SDIL was associated with anticipatory changes in purchases of soft drinks prior to implementation of the SDIL in April 2018. We explored differences in the volume of and amount of sugar in household purchases of drinks in each levy tier at 2 years post announcement. Methods and findings We used controlled interrupted time series to compare observed changes associated with the announcement of the SDIL to the counterfactual scenario of no announcement. We used data from Kantar Worldpanel, a commercial household purchasing panel with approximately 30,000 British members that includes linked nutritional data on purchases. We conducted separate analyses for drinks liable for the SDIL in the higher, lower, and no-levy tiers controlling with household purchase volumes of toiletries. At 2 years post announcement, there was no difference in volume of or sugar from purchases of higher-levy-tier drinks compared to the counterfactual of no announcement. In contrast, a reversal of the existing upward trend in volume (ml) of and amount of sugar (g) in purchases of lower-levy-tier drinks was seen. These changes led to a −96.1 ml (95% confidence interval [CI] −144.2 to −48.0) reduction in volume and −6.4 g (95% CI −9.8 to −3.1) reduction in sugar purchased in these drinks per household per week. There was a reversal of the existing downward trend in the amount of sugar in household purchases of the no-levy drinks but no change in volume purchased. At 2 years post announcement, these changes led to a 6.1 g (95% CI 3.9–8.2) increase in sugar purchased in these drinks per household per week. There was no evidence that volume of or amount of sugar in purchases of all drinks combined was different from the counterfactual. This is an observational study, and changes other than the SDIL may have been responsible for the results reported. Purchases consumed outside of the home were not accounted for. Conclusions The announcement of the UK SDIL was associated with reductions in volume and sugar purchased in lower-levy-tier drinks before implementation. These were offset by increases in sugar purchased from no-levy drinks. These findings may reflect reformulation of drinks from the lower levy to no-levy tier with removal of some but not all sugar, alongside changes in consumer attitudes and beliefs. Trial registration ISRCTN Registry ISRCTN18042742.


2010 ◽  
Vol 31 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Benedetta Allegranzi ◽  
Hugo Sax ◽  
Loséni Bengaly ◽  
Hervé Riebet ◽  
Daouda K. Minta ◽  
...  

Objective.To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country.Design.A before-and-after study from December 2006 through June 2008, with a 6-month baseline evaluation period and a follow-up period of 8 months from the beginning of the intervention.Setting.University Hospital, Bamako, Mali.Participants.TWO hundred twenty-four healthcare workers.Methods.The intervention consisted of introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Hand hygiene infrastructure, compliance, healthcare workers' knowledge and perceptions, and handrub consumption were evaluated at baseline and at follow-up.Results.Severe deficiencies in the infrastructure for hand hygiene were identified before the intervention. Local handrub production and quality control proved to be feasible, affordable, and satisfactory. At follow-up, handrubbing was the quasi-exclusive hand hygiene technique (93.3%). Compliance increased from 8.0% at baseline to 21.8% at follow-up (P< .001). Improvement was observed across all professional categories and medical specialities and was independently associated with the intervention (odds ratio, 2.50; 95% confidence interval, 1.8-3.5). Knowledge enhanced significantly (P< .05), and perception surveys showed a high appreciation of each strategy component by staff.Conclusions.Multimodal hand hygiene promotion is feasible and effective in a low-income country. Access to handrub was critical for its success. These findings motivated the government of Mali to expand the intervention nationwide. This experience represents a significant advancement for patient safety in developing countries.


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