Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study

Grayson, M. Lindsay; Stewardson, Andrew J.; Russo, Philip L.; Ryan, Kate; Olsen, Karen L; Havers, Sally; Greig, Susan; Cruickshank, Marilyn

doi:10.1016/s1473-3099(18)30491-2

Cited by 65 publications

(65 citation statements)

References 22 publications

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“…Australian investigators, for example, showed an improvement from 63.6% to 84.3% adherence in 937 hospitals after an 8-year follow-up study of a national intervention program. 22 Possible next steps that could help Japanese hospitals achieve improved health care worker hand hygiene adherence include obtaining stronger government and hospital leadership support, 23 ensuring that all Japanese hospitals have an appropriate number of infection prevention specialists, 24 and possibly using electronic monitoring systems. 25 To improve the generally low adherence in emergency departments in Japan, education regarding the appropriate timing of hand hygiene may be required in such time-constrained environments.…”

Section: Discussionmentioning

confidence: 99%

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Sakihama

Kayauchi

Kamiya

et al. 2020

American Journal of Infection Control

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Background: Our goal was to evaluate the 5-year sustainability of a multimodal intervention that included a prize to the hospital with the highest overall hand hygiene adherence rates among health care workers. Methods: We conducted an observational study in 3 Japanese tertiary care hospitals using unobtrusive direct observation of physician and nurse hand hygiene adherence. Observations were performed by a trained observer on inpatient medical, surgical, intensive care, and emergency units. The primary outcome was hand hygiene adherence rates before patient contact. Secondary outcomes were health care worker survey responses to a World Health Organization (WHO) questionnaire on hand hygiene practices. Results: Hand hygiene adherence rates had improved significantly after the introduction of a multimodal intervention (based on principles recommend by the WHO) in 2012 and 2013 (from 18.0% pre-intervention to 32.7% 6 months post-intervention; P < .001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5 years after intervention; P = .53); however, substantial variability in hand hygiene adherence by unit and health care worker type was noted. Conclusions: A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention.

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Section: Discussionmentioning

confidence: 99%

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Sakihama

Kayauchi

Kamiya

et al. 2020

American Journal of Infection Control

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“…In the literature, primarily regarding hospital care, moment 4 generally has the highest compliance, followed by moment 3. [29][30][31][32][33][34][35][36][37][38] These are both moments after an HH-indicated activity. These moments may be prioritized because the healthcare provider wants to protect himself or herself.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,7 A few other intervention studies distinguished differences in HHC at the different HH moments, although none of these studies had a control arm. [35][36][37][38] The HHC in the HANDSOME intervention was consistently low for all moments at baseline, whereas the other studies showed high fluctuations among the different moments. 29,[35][36][37][38] The largest gains in other studies were generally at moments 1 and 5.…”

Section: Discussionmentioning

confidence: 99%

“…[35][36][37][38] The HHC in the HANDSOME intervention was consistently low for all moments at baseline, whereas the other studies showed high fluctuations among the different moments. 29,[35][36][37][38] The largest gains in other studies were generally at moments 1 and 5. In our study, the largest differences between the control and intervention arms occurred in the follow-up period at moments 1 and 5, but the largest absolute gains in the intervention arm occurred at moments 3, 4, and 5.…”

Section: Discussionmentioning

confidence: 99%

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Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

Teesing

Erasmus

Nieboer

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes. Design, setting, and participants: HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded. Intervention: Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty. Results: HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%). Conclusions: The HANDSOME intervention is successful in improving HHC in nursing homes.

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“…Hand hygiene (HH) plays a key role in preventing hospital-acquired infections, as it prevents the spread of infectious organisms from patient to patient through the contamination of healthcare workers(HCWs)' hands [1][2][3]. The World Health Organization (WHO) published a multimodal strategy to improve hand hygiene compliance in 2009 [4], and improved HH has been reported from several areas following national and subnational HH campaigns based on the WHO guidelines [3,[5][6][7]. However, there have been no active national or sub-national initiatives in Japan, and a study on HH compliance in 4 Japanese teaching hospitals reported an overall compliance of 19% [8].…”

Section: Introductionmentioning

confidence: 99%

The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.

Suzuki

Morino²,

Morita

et al. 2020

Preprint

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Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score.Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

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Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study

Cited by 65 publications

References 22 publications

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.

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