Improving healthcare worker hand hygiene adherence before patient contact: a before-and-after five-unit multimodal intervention in Tuscany

Saint, Sanjay; Conti, Andrea A.; Bartoloni, Alessandro; Virgili, Gianni; Mannelli, Francesco; Fumagalli, Stefano; Martino, Paolo Di; Conti, Antonio; Kaufman, Samuel R.; Rogers, Mary A.M.; Gensini, Gian Franco

doi:10.1136/qshc.2009.032771

Cited by 32 publications

(32 citation statements)

References 38 publications

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“…In fact, it has been shown that many reasons for non compliance are given, but vigilant in-house infection control teams can facilitate compliance [11,32].…”

Section: Discussionmentioning

confidence: 99%

Ugandan medical and health sciences interns’ infection control knowledge and practices

Kamulegeya

Kizito

Balidawa

2013

J Infect Dev Ctries

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We assessed the level of knowledge, attitudes, and practices of recent graduates of clinical health sciences who started their one-year internship in Uganda. Methodology: This was a cross-sectional survey responded to by 209 (response rate of 70%) new interns who started their internships in August 2011 in different Ugandan hospitals. Validated self-administered questionnaires with knowledge, attitude, and practices questions were distributed to the participants during a two-day internship orientation organized by the national internship committee. Results: Out of 299 subjects approached, the survey was completed and returned by 209 (70%). More nurses (51.4%) failed the questions on odds of HIV transmission after a needle stick injury compared to 23.0% and 36.4% of medical and dental graduates ,respectively(χ 2 = 24.06 p = 0.001). There was no difference in proportions of those who re-sheath needles. Respondents who had an encounter with positive tuberculosis history when taking clinical notes while unprotected were not more motivated to use masks (χ 2 = 7.06; p = 0.07). Nurses and dentists reported more regular hand washing before and after patient contact compared to medical doctors. Conclusion: Overall, the knowledge of infection control was not impressive and the attitudes and practices appeared to be heavily influenced by the lack of an enabling environment in training hospitals and internship hospitals. There is little likelihood of change due to internship experience except for those who go to missionary hospitals that have stricter infection control protocols. More effort must be made in teaching hospitals to encourage better infection control.

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“…In fact, it has been shown that many reasons for non compliance are given, but vigilant in-house infection control teams can facilitate compliance [11,32].…”

Section: Discussionmentioning

confidence: 99%

Ugandan medical and health sciences interns’ infection control knowledge and practices

Kamulegeya

Kizito

Balidawa

2013

J Infect Dev Ctries

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“…19 Appropriate hand hygiene was defined as the use of soap and water or alcohol-based hand rub before patient contact, which corresponds to the first moment of the WHO's 5 moments of hand hygiene. 11 Hand hygiene practice prior to patient contact for each individual provider-patient encounter was observed and recorded using the hand hygiene observation form adapted from a previous study by Saint et al 6,20 Identical to the preintervention study, 19 the form captured the following information: unit in which observations were performed, time of initiation and completion of observations, healthcare worker subgroup (physician or nurse), and the type of hand hygiene before patient contact (ie, hand washing with soap and water, use of alcohol-based hand rub, or no hand hygiene). Unit physicians and nurses were informed that their clinical practices were going to be observed, but were not informed of the purpose of the observations (eg, hand hygiene adherence).…”

Section: Observation Of Hand Hygiene Practicementioning

confidence: 99%

“…4 In Japan, nearly 9% of patients admitted to the intensive care unit (ICU) develop an infection during hospitalization, 5 and 5% of all patients hospitalized become infected with methicillinresistant Staphylococcus aureus. 6 The management of healthcare-associated infections in Japan accounts for up to 5% of total annual healthcare costs, with an estimated $6.8 billion estimated to be potentially preventable. 7 In addition, healthcare-associated infections are associated with increased length of stay in the hospital.…”

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confidence: 99%

“…9 Improving hand hygiene practice for healthcare workers is considered a core strategy to decrease the incidence of healthcare-associated infection. 6,10 Specifically, the use of alcohol-based hand rub is strongly recommended in acute care hospitals by both the World Health Organization (WHO) and the US Centers for Disease Control and Prevention. 11,12 Improving hand hygiene adherence may reduce healthcareassociated infection by 9% to 50%, 13,14 and multiple studies have reported that greater use of alcohol-based hand rubs results in significant reductions in healthcare-associated infections.…”

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confidence: 99%

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Improving healthcare worker hand hygiene adherence before patient contact: A multimodal intervention of hand hygiene practice in Three Japanese tertiary care centers

Sakihama

Honda

Saint

et al. 2015

Journal of Hospital Medicine

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BACKGROUND Though hand hygiene is an important method of preventing healthcare‐associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%–25%). OBJECTIVE Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. SETTING A total of 3 to 4 inpatient wards in 3 Japanese hospitals. DESIGN Pre‐post intervention study. INTERVENTION The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. MEASUREMENT We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre‐intervention adherence rates. RESULTS We observed 2982 postintervention provider‐patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre‐ to 33% postintervention; P < 0.001), but postintervention adherence rates varied considerably: hospital A + 29%, B + 5%, C + 8%. Hospital A won the contest with 40% adherence after the intervention. CONCLUSIONS Using a novel contest coupled with a multimodal intervention successfully improved hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary. Journal of Hospital Medicine 2016;11:199–205. © 2015 Society of Hospital Medicine

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“…In this context, studies such as the one by Saint and colleagues3 seek to demonstrate both that hand hygiene can be improved and how it can be improved (see page ) . This is information we sorely need.…”

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confidence: 99%

Improving healthcare worker hand hygiene: show me more!

Kirkland

2009

Quality and Safety in Health Care

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Improving healthcare worker hand hygiene adherence before patient contact: a before-and-after five-unit multimodal intervention in Tuscany

Cited by 32 publications

References 38 publications

Ugandan medical and health sciences interns’ infection control knowledge and practices

Ugandan medical and health sciences interns’ infection control knowledge and practices

Improving healthcare worker hand hygiene adherence before patient contact: A multimodal intervention of hand hygiene practice in Three Japanese tertiary care centers

Improving healthcare worker hand hygiene: show me more!

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