A successful multifaceted strategy to improve hand hygiene compliance rates

Midturi, John; Narasimhan, Aarthi; Barnett, Teresa; Sodek, Jamie; Schreier, William; Barnett, Jesse; Wheeler, Charlotte; Barton, Libby; Stock, Eileen M.; Arroliga, Alejandro C.

doi:10.1016/j.ajic.2015.01.024

Cited by 20 publications

(31 citation statements)

References 14 publications

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“…The absence of leadership engagement in this study could also have been partially responsible for the modest improvement. Effective leadership involvement can improve hand hygiene compliance (25,26). Continuing efforts and further interventions are needed to address such issues.…”

Section: Discussionmentioning

confidence: 99%

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Hand hygiene initiative: comparative study of pre- and postintervention outcomes

Fouad¹,

Eltaher²

2020

East Mediterr Health J

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Background: Adequate hand hygiene is considered the most effective measure to reduce transmission of nosocomial pathogens. Aims: To determine the effectiveness of infection control intervention to improve compliance with hand hygiene in the Emergency Department, Al-Leith General Hospital, Saudi Arabia, and evaluate bacterial load on hands as a possible indicator of improvement. Methods: The study consisted of 3 phases: Phase I, measurement of basal hand hygiene compliance level; Phase II, multimodal hand hygiene educational programme was initiated; and Phase III, hand hygiene compliance level was measured again. Data were collected by direct observation of healthcare workers in the emergency department between October 2016 and March 2017, using the standardized World Health Organization method for direct observation, "Five Moments for Hand Hygiene". The intervention comprised health education sessions using direct personal contact. Hands of healthcare workers were sampled during Phases I and III by sterile bag method, and bacterial load was determined. Results: A total of 1374 opportunities for hand hygiene were observed during the triphase study. Implementation of the interventional hand hygiene educational programme significantly improved compliance with hand hygiene guidelines from 30.7% to 45.5% (P < 0.01). Log10 bacterial load per hand dropped from 4.97 (standard deviation = 0.32) to 4.57 (0.47) (P < 0.05). Conclusions: Hand hygiene educational programmes were effective in improving compliance in the emergency department, and bacterial load on hands of healthcare workers could be used as an indicator of improvement in hand hygiene compliance.

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Section: Discussionmentioning

confidence: 99%

“…Absence of leadership has been linked with loss of sustainable change in hand hygiene compliance (34). Other studies have shown that inclusion of administrative leadership is linked with improvements in hand hygiene compliance rates and most importantly with enhanced sustainability of such improvements (25,26).…”

Section: Discussionmentioning

confidence: 99%

Hand hygiene initiative: comparative study of pre- and postintervention outcomes

Fouad¹,

Eltaher²

2020

East Mediterr Health J

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“…Twenty one publications were included: eleven randomised trials [6,7,8,9,10,11,12,13,14,15,16]; one non-randomised trial [17]; and nine interrupted time series [ITS] studies meeting specific criteria adopted by the Cochrane Collaboration [18,19,20,21,22,23,24,25,26].…”

Section: Included Publicationsmentioning

confidence: 99%

Applying thematic synthesis to interpretation and commentary in epidemiological studies: identifying what contributes to successful interventions to promote hand hygiene in patient care

et al. 2020

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ObjectivesHand hygiene is considered the most important preventive measure for healthcare-associated infections, but adherence is suboptimal. We previously undertook a Cochrane Review that demonstrated that interventions to improve adherence are moderately effective. Impact varied between organisations and sites with the same intervention and implementation approaches. This study seeks to explore these differences.MethodsA thematic synthesis was applied to the original authors’ interpretation and commentary that offered explanations of how hand hygiene interventions exerted their effects and suggested reasons why success varied. The synthesis used a published Cochrane Review followed by three-stage synthesis.ResultsTwenty-one papers were reviewed: 11 randomised, 1 non-randomised and 9 interrupted time series studies. Thirteen descriptive themes were identified. They reflected a range of factors perceived to influence effectiveness. Descriptive themes were synthesised into three analytical themes: methodological explanations for failure or success (eg, Hawthorne effect) and two related themes that address issues with implementing hand hygiene interventions: successful implementation needs leadership and cooperation throughout the organisation (eg, visible managerial support) and understanding the context and aligning the intervention with it drives implementation (eg, embedding the intervention into wider patient safety initiatives).ConclusionsThe analytical themes help to explain the original authors’ perceptions of the degree to which interventions were effective and suggested new directions for research: exploring ways to avoid the Hawthorne effect; exploring the impact of components of multimodal interventions; the use of theoretical frameworks for behaviour change; potential to embed interventions into wider patient safety initiatives; adaptations to demonstrate sustainability; and the development of systematic approaches to implementation. Our findings corroborate studies exploring the success or failure of other clinical interventions: context and leadership are important.

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“…A similar study was conducted in Albania and it was concluded that for effective control of NI is needed infection control personnel for the implementation of appropriate procedures, and microbiologists to advice on antibiotics policy (6). Through different methods, many other authors, tried to evaluate the impact of implementing the updated World Health Organization (WHO) multi modal HH guidelines on HH compliance and HAIs (7-11). …”

Section: Introductionmentioning

confidence: 99%

Training as an Effective Tool to Increase the Knowledge About Hand Hygiene Actions. An Evaluation Study of Training Effectiveness in Kosovo

Sopjani¹,

Jahn²,

Behrens³

2017

Med Arch

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Introduction:Hand hygiene (HH) compliance with World Health Organization (WHO) guidelines is essential to prevent bacterial transmission and infections acquired from hospital settings.Aim:The aim of this study was to evaluate the impact of training tool of World Health Organization’s (WHOs) Hand Hygiene multi modal campaign at all public hospitals and at the University Clinical Center in Kosovo (UCCK).Method:During February 2016, 691 questionnaires were distributed to health care workers. The data collection was conducted through a questionnaire distributed before and after training. Measurement of questions was realized through a 5 point Likert scale.Results:The gender structure of participants turned out to be greater for women (n=571, 85%). The knowledge of health care workers differed significantly before and after the training (p<0.001), emphasizing that the impact of the training was important to improve the knowledge of participants. Thus, the average value of improvement of HCW’ knowledge was about 41.66 %.Conclusion:The findings emphasized the role of the training to improve the knowledge of participants about hand hygiene as well as prevention from infection.

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A successful multifaceted strategy to improve hand hygiene compliance rates

Cited by 20 publications

References 14 publications

Hand hygiene initiative: comparative study of pre- and postintervention outcomes

Hand hygiene initiative: comparative study of pre- and postintervention outcomes

Applying thematic synthesis to interpretation and commentary in epidemiological studies: identifying what contributes to successful interventions to promote hand hygiene in patient care

Training as an Effective Tool to Increase the Knowledge About Hand Hygiene Actions. An Evaluation Study of Training Effectiveness in Kosovo

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