Cluster Randomized Trial to Evaluate the Effect of a Multimodal Hand Hygiene Improvement Strategy in Primary Care

Martín-Madrazo, Carmen; Soto-Díaz, Sonia; Dorado, Asunción Cañada; Salinero-Fort, Miguel Á.; Medina-Fernández, Manuela; Pau, Enrique Carrillo de Santa; Gómez-Campelo, Paloma; Abánades-Herranz, Juan Carlos

doi:10.1086/666343

Cited by 34 publications

(62 citation statements)

References 38 publications

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“…[2][3][4]12 The World Health Organization (WHO) has recommended a multimodal strategy to improve and sustain hand hygiene compliance, 13 and its effectiveness has been demonstrated. [14][15][16][17][18] The Institute for Healthcare Improvement (IHI) has supported health systems in their own initiatives. In doing so, it has developed tools and methods.…”

mentioning

confidence: 99%

Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

Staines

Amherdt

Lécureux³

et al. 2017

Infect. Control Hosp. Epidemiol.

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objective. To assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative.design. Multicenter analysis of hand hygiene compliance through direct observation by trained observers.setting. A total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland.participants. Clinical staff.interventions. In total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449-6,852). An 18-month Hand Hygiene Breakthrough Collaborative was conducted to implement the WHO multimodal promotional strategy including improved access to alcohol-based hand rub, education, performance measurement and feedback, reminders and communication, leadership engagement, and safety culture.results. Overall hand hygiene compliance improved from 61.9% to 88.3% (P < .001) over 18 months and was sustained at 88.9% (P = .248) 12 months after the intervention. Hand hygiene compliance among physicians increased from 62% to 85% (P < .001) and finally 86% at followup (P = .492); for nursing staff, compliance improved from 64% to 90% (P < .001) and finally 90% at follow-up (P = .464); for physiotherapists compliance improved from 50% to 90% (P < .001) and finally 91% at follow-up (P = .619); for X-ray technicians compliance improved from 45% to 80% (P < .001) and finally 81% at follow-up (P = .686). Hand hygiene compliance also significantly increased with sustained improvement across all hand hygiene indications and all hospitals.conclusions. A rigorously conducted multicenter project combining the Breakthrough Collaborative method for its structure and the WHO multimodal strategy for content and measurement was associated with significant and substantial improvement in compliance across all professions, all hand hygiene indications, and all participating hospitals.

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mentioning

confidence: 99%

Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

Staines

Amherdt

Lécureux³

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…However, in view of the available national and international literature on HH, low compliance with established practices is evident, jeopardizing both user and professional safety (8,11) . In the extra-hospital environment, these data are still incipient (13)(14)(15)(16)(17)(18) . A Spanish study, carried out at PHC and in a hospital environment, found gaps in the knowledge of health professionals regarding the concept of hands hygiene and the use of alcohol solution (16) .…”

Section: Discussionmentioning

confidence: 99%

“…A study carried out at the PHC in Madrid, where adherence to HH was observed at the five points indicated by the World Health Organization (WHO), resulted in a value of 8.1% of adherence (13) . In Nigeria, a study showed that nurses demonstrated good knowledge regarding infection control, but did not reflect on the level of adherence to practices (26) .…”

Section: Discussionmentioning

confidence: 99%

“…The achievement of this is also justified by the relevance of HCAI transmission in PHC, the rare epidemiological reports on this population (5) , the acknowledged deficit of adherence to StanP and SpeP by health professionals in general (11) , the difficulty of comparison between the results of the few recent studies in this care setting (12)(13)(14)(15)(16) and the limited availability of assessment tools (17)(18) , which have not yet been validated.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge about precautions in Primary Health Care: tool validation

Sako

Felix²,

Kawagoe

et al. 2018

Rev. Bras. Enferm.

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Objective To elaborate and validate a tool to assess knowledge and behavior of nursing professionals about standards and specifi c precautions in the Primary Health Care. Method: Methodological study of the elaboration and validation of the tool by thirteen experts judges, using a Likert scale of 4 points, with Content Validity Index ≥ 0.80, on clarity, relevance and pertinence. Results: A tool composed of 47 dichotomous questions to assess knowledge and 12 questions, with fi ve options of answers, for the referred behavior. In the validation, only one item was deleted, related to the "Hands Hygiene" axis and one item was reformulated, regarding "Use of Common Gloves" and another 11 changed writing. The tool as a whole was assessed for relevance, comprehensiveness and representativeness within the scope of the topic investigated. Conclusion: The developed tool has been validated and is now available for use in Primary Health Care. Descriptors: Primary Health Care; Universal Precautions; Validation Studies; Nursing; Continuing Education in Nursing. RESUMO Objetivo: Elaborar e validar instrumento para avaliação do conhecimento e comportamento referido dos profi ssionais de enfermagem sobre precauções padrão e específi ca na Atenção Primária à Saúde. Método: Estudo metodológico de elaboração e validação do instrumento, por treze juízes especialistas, por meio de escala tipo Likert de 4 pontos, com Índice de Validade de Conteúdo ≥ 0,80, sobre clareza, relevância e pertinência. Resultados: Instrumento composto por 47 perguntas dicotômicas para avaliar o conhecimento e 12 perguntas, com cinco opções de respostas, para o comportamento referido. Na validação, apenas um item foi excluído, relativo ao eixo "Higiene das mãos" e um item foi reformulado, relativo a "Uso de luvas" e outros 11 passaram por alteração de redação. Foi avaliado o conjunto do instrumento quanto à relevância, abrangência e representatividade dentro do escopo do tema investigado. Conclusão: A ferramenta desenvolvida foi validada e está agora disponível para uso na Atenção Primária à Saúde. Descritores: Atenção Primária à Saúde; Precauções Universais; Estudos de Validação; Enfermagem; Educação Continuada em Enfermagem. RESUMENObjetivo: Elaborar y validar instrumento para evaluación del conocimiento y comportamiento referido de los profesionales de enfermería sobre precauciones estándar y específi ca en la Atención Primaria a la Salud. Método: Estudio metodológico de elaboración y validación del instrumento, por trece jueces especialistas, por medio de escala tipo Likert de 4 puntos, con Índice de Validez de Contenido ≥ 0,80, sobre claridad, relevancia y pertinencia. Resultados: Instrumento compuesto por 47 preguntas dicotómicas para evaluar el conocimiento y 12 preguntas, con cinco opciones de respuestas, para el comportamiento referido. En la validación, sólo un ítem fue excluido, relativo 1590Knowledge about precautions in Primary Health Care: tool validation Sako MP, Felix AMS, Kawagoe JY, Padoveze MC, Ferreira SA, Zem-Mascarenhas SH, et ...

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“…Although it is a simple, inexpensive, and effective measure, hand hygiene compliance often remains obstinately low, with estimated compliance rates below 50%. 31,32 The ideal targets for hand hygiene compliance rates have been estimated in a number of studies. McBryde et al 11 estimated that a compliance rate of at least 48% was required to eradicate MRSA colonization, whereas the figure estimated by Pressley et al 22 was 70% for the same pathogen.…”

Section: Effectiveness Of Infection Control Measures Investigated Usimentioning

confidence: 99%

Optimizing Hospital Infection Control: The Role of Mathematical Modeling

Doan

Kong

Kirkpatrick

et al. 2014

Infect. Control Hosp. Epidemiol.

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Multidrug-resistant bacteria are major causes of nosocomial infections and are associated with considerable morbidity, mortality, and healthcare costs. Preventive strategies have therefore become increasingly important. Mathematical modeling has been widely used to understand the transmission dynamics of nosocomial infections and the quantitative effects of infection control measures. This review will explore the principles of mathematical modeling used in nosocomial infections and discuss the effectiveness of infection control measures investigated using mathematical modeling.

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Cluster Randomized Trial to Evaluate the Effect of a Multimodal Hand Hygiene Improvement Strategy in Primary Care

Abstract: This study has demonstrated that hand hygiene compliance in primary healthcare workers can be improved with a multimodal hand hygiene improvement strategy.

Cited by 34 publications

References 38 publications

Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

Knowledge about precautions in Primary Health Care: tool validation

Optimizing Hospital Infection Control: The Role of Mathematical Modeling

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