scholarly journals The impact of interventions to improve compliance in hand hygiene – a prospective study from Sangre Grande Hospital

2018 ◽  
Author(s):  
Rajeev Nagassar ◽  
Roma Bridgelal-Nagassar ◽  
Keston Daniel ◽  
Lima Harper
Keyword(s):  
Hand Hygiene ◽  
Prospective Study ◽  
Compliance Rate ◽  
Hospital Setting ◽  
Educational Interventions ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
A Prospective Study ◽  
The Impact

Objectives To assess the compliance of hand hygiene (HH) practices of staff and determine the impact of multimodal interventions to improve hand hygiene practices. Methods A prospective study was conducted to determine the hand hygiene (HH) practices of staff according to the World Health Organization’s “5 moments of HH”. During random visits to the general wards, HH practices of staff were observed for 41 weeks during 2014-15. During the first 8 weeks, the basic compliance rate (BCR) was calculated. A BCR of 50% or more was considered compliant. Data were provided to the staff via email. Toolbox talks, posters, and other educational interventions were instituted in a multimodal manner. Wards were visited by infection control staff to reinforce HH practices. During the post-intervention phase, the HH practices were reassessed for 33 weeks to compare the impact of interventions. Results A total of 13,120 observations were made. Participants ranged from ages 18 to 65. The overall average BCR before intervention was 34.1%, for the first 8 weeks, while it increased to 62.3%, over the next 33 weeks, after the multimodal interventions (p =0.007). The wards which showed significant improvement include Paediatrics (p <0.0001), Male Surgical (p = 0.001), Female Surgical (p = 0.005), Male Medical (p < 0.0001), Haemodialysis Unit (p < 0.0001), ICU, (p = 0.038), and Accident and Emergency (p = 0.007). Obstetric, Female Medical, and Oncology wards did not show statistically significant improvement. Conclusion Hand Hygiene compliance rate of staff can be improved by multimodal interventions in a General Hospital setting.

A Quality Improvement Initiative to Increase Hand Hygiene Awareness and Compliance in a Neonatal Intensive Care Unit in Haiti

2020 ◽  
Author(s):  
Theony Deshommes ◽  
Christian Nagel ◽  
Richard Tucker ◽  
Lindsay Dorcélus ◽  
Jacqueline Gautier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Educational Interventions ◽  
World Health ◽  
Quality Improvement Initiative ◽  
Patient Contact ◽  
Post Intervention

Abstract Introduction Healthcare-associated infections (HCAI) are major causes of morbidity, mortality, increased lengths of stay and are an economic burden on healthcare systems in resources-limited settings. This is especially true for neonates, who are more susceptible with underdeveloped immune systems. Hand hygiene (HH) is a key weapon against HCAI, yet globally, HH compliance remains substandard. This study sought to determine the compliance with HH among healthcare workers (HCWs) in a children’s hospital neonatal intensive care unit (NICU) in Haiti. Methods A HH educational intervention was performed in the NICU, including lectures and posters. Pre- and post-intervention HH data were collected on HCWs and parents using the World Health Organization ‘5 Moments for HH’. Data were analyzed using standard statistical analysis. Results HH increased in all HCW roles but not in parents. Correct HH increased in all groups, including parents. HH was more likely to occur prior to patient contact than after patient contact. Correct HH was more likely to occur with alcohol-based hand rub than with soap and water. Conclusion This study demonstrates that an inexpensive and simple intervention can significantly increase HH compliance in a resource-limited NICU, which may lead to decreased rates of hospital-acquired sepsis. Parents, however, due to cultural norms as well as literacy and language barriers, need targeted educational interventions distinct from those that HCW benefit from.

Improving hand hygiene compliance with patient zone demarcation: More than just lines on the floor

2018 ◽  
Vol 24 (3) ◽  
pp. 100-107 ◽  
Author(s):  
Shanqing Yin ◽  
Phaik Kooi Lim ◽  
Yoke Hwee Chan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Time Pressure ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Positive Effects ◽  
Hygiene Compliance

Background Hand hygiene compliance can be difficult to improve as this prospective activity may not come to mind easily during busy clinical operations. Clinicians are often driven by clinical goals under time pressure, and the sudden recall to clean hands can either be disruptive or too late. Using patient zones as a reference has been known to be helpful. A low-tech solution of taping patient zones on the floor was introduced in a children’s intensive care unit. Coupled with this demarcation is a simplified protocol that uses patient zones for “just-in-time” reminders. Clinicians now clean their hands whenever they cross zone lines, namely “ before patient zone” and “ after patient zone”, along with “ before aseptic procedure” and “ after bodily fluids exposure”. Methods The mandatory national quarterly hand hygiene surveillance data for children’s intensive care unit and the entire hospital was tracked. Seven pre-intervention and seven post-intervention quarters were compared for improvement and sustainability. Results Overall, children’s intensive care unit hand hygiene compliance rose from an average of 77% to 90%, as well as physicians' hand hygiene compliance rates from 72% to 86%, and these differences are statistically significant. Hand Hygiene Moment 1 as defined by World Health Organization benefited the most from this intervention. Discussion Patient zone demarcation, along with more intuitive hand hygiene guidelines, is a cost-effective, operationally sensitive intervention that can improve hand hygiene compliance. The bundled solution taps on human factors science in understanding the cognitive challenges faced by clinicians. The positive effects are most profound in multi-bed cubicles where patient zones and infection control barriers are not clearly visible.

Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa

2016 ◽  
Vol 37 (7) ◽  
pp. 834-839 ◽  
Author(s):  
Ian C. Holmen ◽  
Celestin Seneza ◽  
Berthine Nyiranzayisaba ◽  
Vincent Nyiringabo ◽  
Mugisha Bienfait ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Low Income ◽  
Rural Hospital ◽  
Sub Saharan Africa ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Quasi Experimental ◽  
Sub Saharan

OBJECTIVETo improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization’s (WHO’s) Guidelines on Hand Hygiene in Health Care.DESIGNThis study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration’s support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation.SETTINGA 160-bed, non-referral hospital in Gitwe, RwandaPARTICIPANTSA total of 12 physicians and 54 nurses participated in this study.METHODSThe intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey.RESULTSOverall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P<.001), and HH knowledge was significantly enhanced (P<.001). The 3 departments included in this study had only 1 sink for 29 patient rooms, and 100% of HH opportunities used ABHR. Hand hygiene compliance was significantly higher among physicians than nurses both before and after the intervention. All measures of HH compliance improved except for “after body fluid exposure,” which was 51.7% before intervention and 52.8% after intervention (P>.05).CONCLUSIONHand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA.Infect Control Hosp Epidemiol2016;37:834–839

scholarly journals An An assessment of the impact of educational interventions on hand hygiene compliance

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Carla Husband ◽  
Abbie McMillan ◽  
Lauren Sweeney
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Research Question ◽  
Small Animal ◽  
Educational Interventions ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Improve Hand Hygiene ◽  
Hygiene Compliance ◽  
The Impact

PICO question In small animal veterinary professions, does implementation of an educational intervention, when compared to no intervention, improve hand hygiene compliance?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically appraised. They were all prospective observational cohort studies Strength of evidence Weak Outcomes reported Two out of the three papers did not find educational implementation to have a statistically significant positive effect on hand hygiene compliance (HHC) in small animal veterinary professionals Conclusion The veterinary evidence reviewed does not provide strong justification for the use of education in the improvement of HHC in small animal practice. This contrasts with extensive human evidence which supports the use of educational interventions (Helder et al., 2010).  However, a limited veterinary knowledge base in the field of HH, combined with the flawed methodologies of the appraised literature, suggests that this finding is not representative of the effect education could have on HHC. The conclusion drawn from the evidence assessed within this Knowledge Summary is that educational interventions are not significantly linked to an improvement in HHC within a small animal veterinary setting. When considering the volume of human evidence which supports education as a tool to improve HHC, the authors suggest this Knowledge Summary should be repeated in the future when additional veterinary evidence is available to reassess the conclusion drawn   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

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

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%.

scholarly journals Hand Hygiene Practices in Medical Students: A Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sajad Ahmad Salati ◽  
Azzam Al Kadi
Keyword(s):  
Medical Students ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Improve Hand Hygiene ◽  
Follow Up Study ◽  
Hygiene Practices ◽  
Hygiene Compliance ◽  
The Impact

Objective. The study was conducted to study the impact of various measures instituted to improve hand hygiene practices of the medical students after having documented poor hand hygiene awareness and compliance in a study conducted in 2012. Methods. A self-designed questionnaire based on World Health Organization’s concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications of hand hygiene. Compliance was observed during Objective Structured Clinical Examination (OSCE) sessions. Fifty-one students participated voluntarily in the study. Results. The awareness and compliance of hand hygiene among the medical students in 2014 had shown statistically significant improvement (P<0.005) as compared to figures of the study conducted in 2012. Conclusion. Dedicated multifaceted intervention can improve the hand hygiene practices in medical students.

scholarly journals Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

2019 ◽  
Vol 16 (4) ◽  
pp. 607 ◽  
Author(s):  
Cam Le ◽  
Erik Lehman ◽  
Thanh Nguyen ◽  
Timothy Craig
Keyword(s):  
Quality Assurance ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Center ◽  
Compliance Rate ◽  
World Health ◽  
Limiting Factors ◽  
Cultural Attitudes ◽  
Knowledge And Attitude ◽  
Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

Abstract No. 294: Optimizing IVC filter utilization: a prospective study of the impact of IR consultation

2012 ◽  
Vol 23 (3) ◽  
pp. S119
Author(s):  
R.K. Ryu ◽  
R.J. Lewandowski ◽  
A.C. Eifler ◽  
R. Salem ◽  
R.A. Omary ◽  
...  
Keyword(s):  
Prospective Study ◽  
Ivc Filter ◽  
A Prospective Study ◽  
The Impact

scholarly journals 141. Implementation of Veterans Affairs Outpatient Antimicrobial Stewardship Interventions for Asymptomatic Bacteriuria and Acute Respiratory Infections, a Stepped Wedge Randomized Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S81-S82
Author(s):  
Grace Mortrude ◽  
Mary Rehs ◽  
Katherine Sherman ◽  
Nathan Gundacker ◽  
Claire Dysart
Keyword(s):  
Patient Satisfaction ◽  
Primary Outcome ◽  
Respiratory Infections ◽  
Asymptomatic Bacteriuria ◽  
Educational Interventions ◽  
Antibiotic Prescribing ◽  
Acute Respiratory Infections ◽  
Stepped Wedge ◽  
Post Intervention ◽  
The Impact

Abstract Background Outpatient antimicrobial prescribing is an important target for antimicrobial stewardship (AMS) interventions to decrease antimicrobial resistance in the United States. The objective of this study was to design, implement and evaluate the impact of AMS interventions focused on asymptomatic bacteriuria (ASB) and acute respiratory infections (ARIs) in the outpatient setting. Methods This randomized, stepped-wedge trial evaluated the impact of educational interventions to providers on adult patients presenting to primary care (PC) clinics for ARIs and ASB from 10/1/19 to 1/31/20. Data was collected by retrospective chart review. An antibiotic prescribing report card was provided to PC providers, then an educational session was delivered at each PC clinic. Patient education materials were distributed to PC clinics. Interventions were made in a step-wise (figure 1) fashion. The primary outcome was percentage of overall antibiotic prescriptions as a composite of prescriptions for ASB, acute bronchitis, upper-respiratory infection otherwise unspecified, uncomplicated sinusitis, and uncomplicated pharyngitis. Secondary outcomes included individual components of the primary outcome, a composite safety endpoint of related hospital, emergency department or primary care visit within 4 weeks, antibiotic appropriateness, and patient satisfaction surveys. Figure 1 Results There were 887 patients included for analysis (405 pre-intervention, 482 post-intervention). Baseline characteristics are summarized in table 1. After controlling for type 1 error using a Bonferroni correction the primary outcome was not significantly different between groups (56% vs 49%). There was a statistically significant decrease in prescriptions for bronchitis (20.99% vs 12.66%; p=0.0003). Appropriateness of prescriptions for sinusitis (OR 4.96; CI 1.79–13.75; p=0.0021) and pharyngitis (OR 5.36; CI 1.93 – 14.90; p=0.0013) was improved in the post-intervention group. The composite safety outcome and patient satisfaction survey ratings did not differ between groups. Table 1 Conclusion Multifaceted educational interventions targeting providers can improve antibiotic prescribing for indications rarely requiring antimicrobials without increasing re-visit or patient satisfaction surveys. Disclosures All Authors: No reported disclosures

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