Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

Mertz, Dominik; Dafoe, Nancy; Walter, Stephen D.; Brazil, Kevin; Loeb, Mark

doi:10.1086/656592

Cited by 48 publications

(79 citation statements)

References 31 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Es konnte gezeigt werden, dass durch die Erhöhung der Compliance mit der Hände-desinfektion eine Verringerung der nosokomialen Infektionen erreicht werden kann [174,175,347,348] [165]. Für Vancomycin-resistente Enterokokken konnten solche Effekte bereits empirisch gezeigt werden [362].…”

Section: B) Tragen Von Schutzkleidung Bei Patientenkontaktunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

122

View full text Add to dashboard Cite

Section: B) Tragen Von Schutzkleidung Bei Patientenkontaktunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

122

View full text Add to dashboard Cite

“…Unobtrusive observation has been employed in a number of studies 23,25,36 . The authors do not provide details of how the procedure was undertaken or how its effectiveness was assessed, not surprisingly as the WHO guidelines 5 do not give advice on either issue.…”

Section: Approaches To Overcoming the Hawthorne Effect During Directlmentioning

confidence: 99%

“…treatment room) resulting in under-estimate of the number of hand hygiene opportunities available and whether or not they were acted on. They can also defer clinical procedures until observation is over, especially if the audit period is brief: in many studies it is 30 minutes or less 22,25,40 . Delaying activities that require multiple hand hygiene events throughout as well as before and afterwards (e.g.…”

Section: Approaches To Overcoming the Hawthorne Effect During Directlmentioning

confidence: 99%

Impact of observing hand hygiene in practice and research: a methodological reconsideration

Gould

Creedon

Jeanes

et al. 2017

Journal of Hospital Infection

View full text Add to dashboard Cite

This is the accepted version of the paper.This version of the publication may differ from the final published version. Direct observation is the recommended audit method but is associated with a number of disadvantages, including potential for being observed to alter usual behaviour. The Hawthorne effect in relation to hand hygiene is equated with productivity by increasing the frequency that hand hygiene is undertaken. Permanent repository linkUnobtrusive and/or frequent observation to accustom staff to the presence of observers are considered acceptable ways of reducing the Hawthorne effect but little has been written about how to implement these techniques or assess their effectiveness. There is evidence that awareness of being watched can disrupt the usual behaviour of individuals in complex and unpredictable ways other than simple productivity effect. Health workers might defer or avoid activities that require hand hygiene in the presence of auditors but these issues are not

show abstract

“…There has been some success reported in the reduction of invasive infection since 2005, but most of the improvement was related to bloodstream infection and may be related to improved central venous catheter management in acute care hospitals (11). Another recent study has shown that a reduction in the rate of MRSA invasive infection must involve more than a general improvement in basic infection control practice, such as improved hand hygiene, since improved hand hygiene did not lower hospitalacquired MRSA colonization (14). MRSA detection is often followed by either decolonization or isolation to reduce MRSA prevalence within hospitals and in the community (4,8,10).…”

mentioning

confidence: 99%

Performance of the BD GeneOhm MRSA Achromopeptidase Assay for Real-Time PCR Detection of Methicillin-Resistant Staphylococcus aureus in Nasal Specimens

et al. 2011

View full text Add to dashboard Cite

We evaluated the BD GeneOhm MRSA achromopeptidase (ACP) assay, which incorporates a new specimen preparation approach. A total of 1,216 leftover nasal samples were tested; using culture as the gold standard, the sensitivity and specificity were 92% and 94.6%, respectively. The new lysis method provides good sensitivity and simplifies specimen preparation.Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of health care-associated infections and is responsible for increased hospital stays with high financial cost (7,19,24). In fact, by 2005 MRSA had a higher mortality rate than tuberculosis, salmonella infection, influenza, and HIV-AIDS combined within the United States (5). Moreover, Delorme and colleagues recently reported an increase of MRSA infections and disease rate in long-term care facility (LTCF) residents between 2006 and 2007 (6). There has been some success reported in the reduction of invasive infection since 2005, but most of the improvement was related to bloodstream infection and may be related to improved central venous catheter management in acute care hospitals (11). Another recent study has shown that a reduction in the rate of MRSA invasive infection must involve more than a general improvement in basic infection control practice, such as improved hand hygiene, since improved hand hygiene did not lower hospitalacquired MRSA colonization (14).MRSA detection is often followed by either decolonization or isolation to reduce MRSA prevalence within hospitals and in the community (4,8,10). In an elegant crossover study of the impact rapid testing has on MRSA transmission, Hardy and colleagues demonstrated significantly reduced transmission when surveillance testing was done using a real-time PCR assay, as opposed to no significant impact when routine, culture-based testing was utilized by the laboratory (9). Thus, rapid and reliable screening tests for MRSA detection are very important. Real-time PCR assays are fast, reliable, and accurate, which has been useful to reduce the incidence of MRSA disease (19,20).Paule and colleagues developed an achromopeptidase (ACP) lysis procedure for high-volume testing and compared its performance with the original BD GeneOhm MRSA lysis kit method (IDI-MRSA assay). The study results demonstrated that the assay performed equally well using both procedures (18). BD Diagnostics subsequently developed an ACP lysis method for use with the BD GeneOhm MRSA kit. The purpose of this current study was to assess the BD GeneOhm MRSA ACP assay for direct detection of MRSA in nasal specimens as part of an application to the U.S. FDA for clearance as an in vitro diagnostic device.Nasal swabs were collected using double-headed BBL culture swabs with liquid Stuart (Becton Dickinson, Sparks, MD) or liquid Amies (Becton Dickinson) transport medium; singleheaded Amies gel swabs without charcoal (Becton Dickinson) were also included. Excess, deidentified nasal specimens were used for testing after routine laboratory procedures were completed. The subjects enrolled ...

show abstract

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

Abstract: Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

Cited by 48 publications

References 31 publications

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Impact of observing hand hygiene in practice and research: a methodological reconsideration

Performance of the BD GeneOhm MRSA Achromopeptidase Assay for Real-Time PCR Detection of Methicillin-Resistant Staphylococcus aureus in Nasal Specimens

Contact Info

Product

Resources

About