Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control

Abstract

BackgroundHarmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries.MethodsWe developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training.ResultsBetween June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively.ConclusionsThe TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.

Improving educator’s knowledge and confidence to teach infection prevention and antimicrobial resistance

“…Educator training workshops have been an effective intervention for similar topics, including physical education (Hivner et al, 2019). HIV and AIDS workshops have significantly improved the knowledge and teaching confidence of secondary school educators (Sarma et al, 2013), and workshops for healthcare professionals have improved hand hygiene behaviour (Bellissimo-Rodrigues et al, 2015;Tartari et al, 2019). Through the high number of healthcare professionals attending the workshops, our study supports the observation that interventions designed for the educational setting may be transferable to healthcare or community settings.…”

Characteristics of personal protective equipment training programs in Australia and New Zealand hospitals: A survey

“…In this study the IPC team was responsible for the majority of PPE training although several respondents reported the use of non-IPC personnel incorporating the trainthe-trainer model, a technique which has been used successfully to improve hand hygiene compliance in Australia and overseas [14,28]. Three respondents have used virtual reality in their training programmes, a technology which can provide individual practical training while eliminating PPE use for training when resources are scarce, as seen in the current COVID-19 pandemic [29].…”

An Investigation of the General Population’s Self-Reported Hand Hygiene Behaviour and Compliance in a Cross-European Setting

“…Currently, the delivery of most hand hygiene education across Europe is founded in healthcare guidance and is primarily aimed towards healthcare professionals like doctors and nurses, and young children under the age of five years old in nursery school settings [ 30 , 31 , 32 , 33 , 34 ]. A key goal of hand hygiene education is in ensuring that the correct number of hand hygiene steps should be followed at key times and that the correct length of time (at least twenty seconds or more) should be adhered too when washing and drying hands [ 21 , 22 ].…”

“…The reasons for differences in the compliance rates of the limited data that is available is difficult to determine. Most hand hygiene behaviour is thought to be inherent in nature and is typically defined at an early age through a mixture of early childhood education on personal hygiene and through the influence of key role models like parents and teachers in reinforcing the behaviour [ 31 , 32 , 33 , 34 ]. Therefore, if hand hygiene education at an early age is inadequate, or influence from key role models is inaccurate, then poor behaviour will persist unless otherwise corrected [ 33 , 34 , 35 ].…”