Impact of hand hygiene on the infectious risk in nursing home residents: A systematic review

Hocine, Mounia; Temime, Laura

doi:10.1016/j.ajic.2015.05.043

Cited by 32 publications

(27 citation statements)

References 67 publications

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“…Three other studies have reported significantly lower hand hygiene adherence in long care facilities in elderly and nursing homes, respectively, 14.7% in Hamilton, Ontario, 17.5% in Italy and 11.3% in Taiwan (Liu, Liang, Wu, & Chuang, ; Pan et al, ; Smith, Carusone, & Loeb, ). In addition, findings from this study confirm the result from a systematic review of the effectiveness of hand hygiene in nursing homes settings, showing that hygiene compliance is low (Hocine & Temime, ). It is notable that the poor hand hygiene compliance in the present study makes it difficult to reach two important goals in international health policy: to reduce infections and to reduce the use of antibiotics (WHO, ).…”

Section: Discussionsupporting

confidence: 85%

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

Løyland

Peveri

Hessevaagbakke

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To use nursing students to observe hand hygiene adherence in nursing homes and to explore whether the students' reflections after observing hand hygiene practices gives them a deeper understanding of the subject matter. Background Residents in nursing homes worldwide have low tolerance for healthcare‐associated infections that require antibiotics, and hand hygiene is the single most effective action to reduce infections. Design Observational study using (a) World Health Organization's (WHO) “Five moments for hand hygiene” validated tool to record indications and adherence and (b) an exploratory study of individual reflection notes from students conducted during and after observations. Methods From February 12–15, 2018, 26 nursing students in their second semester of a 3‐year bachelor programme participated as observers in five wards in four nursing homes in the Oslo metropolitan area. This study was performed according to the STROBE statement. Results Hand hygiene was performed for 57.2% of the 2,393 indications observed and recorded. Adherence differed significantly by type of personnel and by location. Four thematic categories emerged from the reflection notes: (a) practical awareness and introspection; (b) visualisation and enhancement of understanding of practice learning; (c) incorrect hand hygiene practices; and (d) stimulation to increase essential knowledge. Conclusion Hand hygiene adherence was too low to prevent healthcare‐associated infections and to reduce the use of antibiotics. The students' reflection notes indicated more “insight and understanding of the complexity of hand hygiene.” We suggest using nursing students in clinical placement as a means of incorporating different interventions as part of their learning skills and become “living reminders” of the importance of hygiene and infection prevention. Relevance for clinical practice Improving the student's activity about hygiene and infection prevention in clinical placement may help to raise awareness by healthcare workers in nursing homes.

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Section: Discussionsupporting

confidence: 85%

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

Løyland

Peveri

Hessevaagbakke

et al. 2019

Journal of Clinical Nursing

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“…This may have led us to over-estimate the role played by inter-individual transmission in norovirus spread dynamics, and, in turn, to over-estimate the impact of interventions which aim at reducing the transmission risk, such as hand hygiene and resident isolation. Indeed, only 25 % of published randomized trials found a significant impact of hand hygiene on the infectious risk in nursing homes [7]. Conversely, other interventions, such as hand hygiene performed by the staff after contacts with the residents’ environment, could probably have been found to have an important impact on norovirus dynamics.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a recent review, there is a strong need for more studies on the impact of hand hygiene-based interventions in long-term care, in particular randomized trials [7]. Because it allows assessing the impact of a wide range of control strategies in a fast and simple manner, the modeling approach we propose is a useful complement to such much-needed studies.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, as person-to-person transmission plays an important part in norovirus spread and compliance with international hygiene recommendations is low in NH staff [6], it is expected that increasing hand hygiene practices could help limit norovirus outbreaks. However, the evidence on hand hygiene effectiveness in NH settings is limited [7] and the way hand hygiene may impact norovirus transmission dynamics is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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The role of hand hygiene in controlling norovirus spread in nursing homes

Assab

Temime

2016

BMC Infect Dis

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BackgroundNorovirus, the leading cause of gastroenteritis, causes higher morbidity and mortality in nursing homes (NHs) than in the community. Hence, implementing infection control measures is crucial. However, the evidence on the effectiveness of these measures in NH settings is lacking. Using an innovative data-driven modeling approach, we assess various interventions to control norovirus spread in NHs.MethodsWe collected data on resident and staff characteristics and inter-human contacts in a French NH. Based on this data, we developed a stochastic compartmental model of norovirus transmission among the residents and staff of a 100-bed NH. Using this model, we investigated how the size of a 100-day norovirus outbreak changed following three interventions: increasing hand hygiene (HH) among the staff or residents and isolating symptomatic residents.ResultsAssuming a baseline staff HH compliance rate of 15 %, the model predicted on average 19 gastroenteritis cases over 100 days among the residents, which is consistent with published incidence data in NHs. Isolating symptomatic residents was highly effective, leading to an 88 % reduction in the predicted number of cases. The number of expected cases could also be reduced significantly by increasing HH compliance among the staff; for instance, by 75 % when assuming a 60 % HH compliance rate. While there was a linear reduction in the predicted number of cases when HH practices among residents increased, the achieved impact was less important.ConclusionsThis study shows that simple interventions can help control the spread of norovirus in NHs. Modeling, which has seldom been used in these settings, may be a useful tool for decision makers to design optimal and cost-effective control strategies.

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“…Several studies through the years have documented the now universally accepted fact that hand hygiene is an effective measure in reducing HAIs. In any early study, Mortimer et al (1962) [19] found that 92% of the infants handled in the nursery by nurses with unwashed hands acquired the strain of an infant carrier, compared to only 53% of the infants that were handled by nurses who washed homes [26].…”

Section: Handwashing: Positive Aspectsmentioning

confidence: 99%

Persistence of Healthcare-Associated (Nosocomial) Infections Due to Inadequate Hand Hygiene: Part 2—Human Factors

Raffa¹,

Pergolizzi²,

Taylor³

et al. 2018

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A healthcare-associated infection (defined as an infection acquired within a healthcare facility), such as due to transmission via medical equipment or by healthcare providers is the most frequent adverse event in the healthcare delivery system. But why does the problem persist, when infection control measures are known, simple, and low-cost? We reviewed some biologicaland treatment-factors in Part 1, and we now review some human-factors. Healthcare-associated infections are a major public health problem even in advanced healthcare systems. They affect hundreds of millions of patients each year, and are responsible for increased morbidity, mortality, and financial burden. This is perplexing, since good-hygiene practices are known and promoted. Disinfection, sterilization, handwashing, and alcohol rubs should be more effective, but human-factors interfere. The persistent high prevalence of nosocomial infections, despite known hygienic practices, is attributable to two categories of factors: biological and inherent shortcomings of some practices (considered in Part 1), and human factors (considered here). A new approach is considered in Part 3.

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Impact of hand hygiene on the infectious risk in nursing home residents: A systematic review

Cited by 32 publications

References 67 publications

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

The role of hand hygiene in controlling norovirus spread in nursing homes

Persistence of Healthcare-Associated (Nosocomial) Infections Due to Inadequate Hand Hygiene: Part 2—Human Factors

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