A multifaceted hospital-wide intervention increases hand hygiene compliance

Abstract

Background. Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. Objective. To show an improvement in hand hygiene compliance using a multifaceted approach. Methods. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with nonintervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Results. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). Conclusion. The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi’an, China

“…In addition, compliance rates for “before” related indications were promoted after intervention, such as “before touching a patient” and “before clean/aseptic procedures”. These findings revealed that HCWs were inclined to wash their hands to protect themselves rather than protect patients from potential infection, which was noted in previous studies [ 31 , 32 ]. As for indication “after touching patient surroundings”, HH opportunities with this indication were most commonly associated with lower levels of compliance than following direct patient contact [ 33 ].…”

Efficacy of the multimodal strategy for Hand Hygiene compliance: an integrative review

“…According to the Global Human Development Index (HDI) (41) , approximately 85% (21/25) of the countries in which the studies included in this review occurred have a very high or high HDI (4)(5)(7)(8)13,(19)(20)(21)(23)(24)(25)(26)(27)(28)(29)(30)(31)(34)(35)(36)(37) . With respect to the medium and low HDI countries (4/25) (18,22,(32)(33) , all had a pre-intervention HH compliance of less than 30%, and a post-intervention compliance of less than 50%, except a study (18) (1/4) that reached 57% after the intervention.…”

“…With regard to greater sustainability over time in HH compliance, interventions that presented educational actions that included the five components of the multimodal strategy maintained higher post-intervention compliance rates (7,8,13,(24)(25)27,36) . The self-sustaining average among these studies was 83%, and some factors, besides those related to infrastructure, can be considered as responsible for such results, such as intervention time, which ranged from three months to one year or more, lectures and workshops used concomitantly by means of practical elucidations, immediate and/or weekly feedback, monthly reports to team leaders and managers, professional effort recognition, placards at strategic locations, screenshots on computers, and institution's commitment to security environment.…”

“…In all searches that had the reminder component in the workplace, educational posters were the preferred choice. Regarding research that explicitly made use of the institutional safety environment component, only three studies (7,23,27) clearly stated that managers and managers committed to follow up on the implementation of the multimodal strategy after the study.…”

Infection prevention and control measures in audiology practice within public healthcare facilities in KwaZulu-Natal province, South Africa

“…Although only 67% of participants believed that it was necessary to wash hands after cerumen management, 88% of participants reported that they washed their hands after cerumen management. However, this is still concerning, as cerumen can be considered an infectious substance and may lead to opportunistic infections, such as methicillin-resistant Staphylococcus aureus (MRSA) (Kemp & Bankaitis, 2000; Patel, Engelbrecht, McDonald, Morris, & Smythe, 2016).…”