Monitoring and feedback of hand hygiene compliance and the impact on facility-acquired methicillin-resistant Staphylococcus aureus

Cromer, Andrea; Latham, Susan C.; Bryant, Kathy G.; Hutsell, Svetlana; Gansauer, Lucy; Bendyk, Heather; Steed, R. Dennis; Carney, Michelle C.

doi:10.1016/j.ajic.2007.12.006

Cited by 35 publications

(21 citation statements)

References 6 publications

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“…Compliance with infection control procedures, one aspect known to have substantial influence on the effectivity of infection control interventions, has not been addressed in the study [24,25]. Hence, appraisal of the study results should take account of this problematic factor.…”

Section: Discussionmentioning

confidence: 92%

The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases

Schweickert

Geffers

Farragher

et al. 2011

Clinical Microbiology and Infection

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Nosocomial infections with methicillin-resistant Staphylococcus aureus (MRSA) account for increased morbidity, mortality and healthcare costs in critically ill patients worldwide. The intensive care unit (ICU) component of the German surveillance system for nosocomial infections (Krankenhaus-Infektions-Surveillance-System, KISS) has been supplemented with a module targeting the surveillance of multiresistant pathogens [Multiresistente Erreger (MRE)-KISS] in order to account for the increasing burden of antibiotic-resistant bacteria. The aim of this study was to assess the association between structural and organizational characteristics of ICUs and the number of nosocomial MRSA cases. Data were derived from routine data collected in the frame of the national surveillance system of nosocomial infections (ICU- and MRE-KISS) from January 2007 to December 2008 and from a questionnaire inquiring about structure and process parameters. One hundred and forty ICUs performing active screening have been included. Process parameters such as isolation of MRSA patients, decolonization procedures and introduction of MRSA alert systems have been implemented by the majority of the ICUs, whereas the application mode of screening procedures and pre-emptive isolation measures is heterogeneous. Multivariable analysis using negative binominal regression models shows that a stay on a medical ICU has a protective effect (incidence rate ratio, 0.42; 95% confidence interval, 0.24-0.74; p = 0.003), whereas the imported MRSA incidence is significantly associated with the number of nosocomial MRSA cases (incidence rate ratio, 1.74; 95% confidence interval, 1.23-2.45; p = 0.002). Structure and process parameters do not show any effect. ICU type and imported MRSA incidence should be considered for benchmarking between hospitals.

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Section: Discussionmentioning

confidence: 92%

The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases

Schweickert

Geffers

Farragher

et al. 2011

Clinical Microbiology and Infection

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“…[5][6][7][8][9] These studies, however, all looked at overall facility-wide HHC and facility-wide infection rates. Our study showed that improvement in HHC at the unit level corresponded to unit-level decreases in health care-associated MRSA infections.…”

Section: Discussionmentioning

confidence: 97%

Electronic hand hygiene monitoring as a tool for reducing health care–associated methicillin-resistant Staphylococcus aureus infection

Kelly

Blackhurst

McAtee

et al. 2016

American Journal of Infection Control

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“…Several methods have been used to promote compliance among healthcare workers such as providing performance feedback [25,26] , engaging patient as an observer for hand hygiene [27] and using an electronic surveillance device [28] . Frequent monitoring of hand hygiene and providing feedback on performance based on behavioural sciences theory should be explored in Kuwait.…”

Section: Discussionmentioning

confidence: 99%

Hand Hygiene Practices among Nursing Staff in Public Secondary Care Hospitals in Kuwait: Self-Report and Direct Observation

et al. 2011

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Objective: To assess the compliance with hand hygiene guidelines among nursing staff in secondary care hospitals in Kuwait. Subjects and Methods: A cross-sectional study was conducted through direct observation using the Lewisham observation tool and self-administered questionnaire in six major public secondary care hospitals in Kuwait. Only patient care activities that are described as ‘dirty contacts’ by the Fulkerson scale were considered as indications for hand hygiene while any attempt for hand hygiene was considered as compliance. A self-administered questionnaire was prepared and pilot tested and then distributed to nursing staff at each ward immediately after conducting the inspection; 550 were distributed and 454 were completed and returned. Among 204 observation sessions, a total of 935 opportunities and 312 hand hygiene practices were recorded. Results: The overall compliance was 33.4%. The observed compliance significantly varied between different ward categories from 14.7% in emergency to 55% in medical wards. Of the 454 nursing staff who participated in self-reported compliance, 409 (90%) indicated that they always washed their hands upon practicing patient care activities. Nurses consistently reported higher compliance after conducting patient care activities rather than before. Being busy with work (42.2%), having sore/dry hands (30.4%) and wearing gloves (20.3%) were the most frequently reported hindrances to improving hand hygiene. Conclusion: Observed hand hygiene compliance among nursing staff in secondary care hospitals in Kuwait was poor. High self-reported compliance may reflect a high level of awareness of hand hygiene but may also suggest that improving compliance through increasing awareness has probably reached saturation.

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Monitoring and feedback of hand hygiene compliance and the impact on facility-acquired methicillin-resistant Staphylococcus aureus

Cited by 35 publications

References 6 publications

The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases

The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases

Electronic hand hygiene monitoring as a tool for reducing health care–associated methicillin-resistant Staphylococcus aureus infection

Hand Hygiene Practices among Nursing Staff in Public Secondary Care Hospitals in Kuwait: Self-Report and Direct Observation

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