A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance

Dijk, Manon D. van; Mulder, Sanne A.; Erasmus, Vicki; Beeck, A. H. Elise van; Vermeeren, Joke M.J.J.; Liu, Xiaona; Beeck, Ed F. van; Vos, Margreet C.

doi:10.1017/ice.2018.261

Cited by 14 publications

(20 citation statements)

References 24 publications

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“…26,36,37 Our experience with this program reinforced the findings of other studies that a multimodal, team-driven, friendly competition and positive-reinforcement-focused approach is crucial for improving hand hygiene, particularly with respect to peer influence and role modeling. 11,12,28,29,38 It also reflects the assertion outlined in other studies that multimodal interventions are necessary for sustained improvement. 26,39,40 Easing concerns about the system's accuracy and increasing comfort were important considerations.…”

Section: Discussionsupporting

confidence: 58%

“…26 Interventions that are associated with improved adherence include providing feedback, rewarding positive behavior, encouraging friendly competition, and conducting educational programs to raise awareness. [26][27][28][29][30] Our institution implemented an RFID-based AHHMS in selected units, coupled with interventions designed to increase hand hygiene adherence. We assessed hand hygiene adherence both electronically and by direct observation, and we studied the effect of AHHMS-measured adherence on HAI rates.…”

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confidence: 99%

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Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Knepper

Miller

Young

2020

Infect. Control Hosp. Epidemiol.

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Objective: Hand hygiene adherence has been associated with reductions in nosocomial infection. We assessed the effect of improvements in electronically measured hand hygiene adherence on the incidence of hospital-acquired infections. Methods: This quasi-experimental study was conducted in a 555-bed urban safety-net level I trauma center. The preintervention period was January 2015 through June 2016. Baseline electronic hand hygiene data collection took place from April through June 2016. The intervention period was July 2016 through December 2017. An electronic hand hygiene system was installed in 4 locations in our hospital. Performance improvement strategies were implemented that included education, troubleshooting, data dissemination, and feedback. Adherence rates were tracked over time. Rates of hospital-acquired infections were evaluated in the intervention units and in control units selected for comparison. The intervention period was subdivided into the initial and subsequent 9-month periods and were compared to the baseline period. Results: Electronically measured hand hygiene rates improved significantly from baseline to intervention, from 47% 77% adherence. Rates >70% continued to be measured 18 months after the intervention. Interrupted time series analysis indicated a significant effect of hand hygiene on healthcare facility-onset Clostridioides difficile infection rates during the first 9 months of the intervention. This trend continued during the final 9 months of the intervention but was nonsignificant. No effects were observed for other hospital-acquired infection rates. Conclusions: Implementation of electronic hand hygiene monitoring and performance improvement interventions resulted in reductions in hospital-onset Clostridioides difficile infection rates.

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Section: Discussionsupporting

confidence: 58%

mentioning

confidence: 99%

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Knepper

Miller

Young

2020

Infect. Control Hosp. Epidemiol.

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“…It is suggested that effective measures should be further implemented to improve compliance rate of caregivers. HH compliance also differed between ward type, with the pediatrics ward in the study showing the highest compliancy of 60%, whereby this nding is higher than other studies in the literature [18,26,29] . Since we made fewer observations in the pediatrics ward, there is a need for more detailed investigation of pediatrics ward so that this result can be con rmed.…”

Section: Discussioncontrasting

confidence: 59%

“…This is often attributed to diagnosed MDRO inpatients and caregivers receiving health education about HH and having access to adequate supplies of equipment like handwashing materials [26,27] . Optimal levels of adherence were not achieved, however, since HH should be performed in at least 80% of case to interrupt cross transmission in settings with high infection risks [28,29] . It is suggested that effective measures should be further implemented to improve compliance rate of caregivers.…”

Section: Discussionmentioning

confidence: 99%

Hand hygiene compliance among caregivers of inpatients with multidrug-resistant organism infection in China: a cross-sectional study

Chang¹,

Chen²,

Wang³

et al. 2020

Preprint

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Background Caregivers are an important provider of daily living care for multidrug-resistant organism (MDRO) inpatients in China, they are at risk for contracting and spreading MDRO from frequent interactions with patients. Improving the hand hygiene (HH) compliance of caregivers has important significance in reducing the incidence of infection. However, we have little information about HH compliance among caregivers of MDRO inpatients in most medical institutions. Therefore, we decide to examine HH compliance among caregivers of MDRO inpatients in China. Methods Using direct observations, we investigated HH compliance among caregivers of MDRO inpatients between March and August 2019 in a large university-affiliated hospital in China. Using the WHO’s Hand Hygiene Observation Tool, we surveyed a total of 440 HH opportunities. Results Out of the total participants, 16.2% were elderly. Overall HH compliance was 46.8%. The most frequent moment for HH was “after a touching patient” (69.2%) and the lowest compliance was “before clean/aseptic procedures” (25.6%). Compliance during “visiting” was highest (66.7%), with hands being less frequently washed during “resting” (29.0%). Conclusions Overall compliance with HH when caring for MDRO inpatients is less than optimal. Elderly caregivers should be valued by society and the public. These results may be used to identify issues and interventions to address HH practices and achieve a reduction in MDRO infections.

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“…This may motivate top management as a key performance indicator for the department. In a friendly competition setting, a multimodal intervention program significantly increases compliance with HH [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Self-Reported Hand Hygiene Performance among Nurses at Tertiary Care Hospitals in East Coast Malaysia

Rahim

Ibrahim

Noor

et al. 2021

IJERPH

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Background: Hand hygiene (HH) is the simplest and most effective way to reduce the incidence of healthcare-associated infections (HCAIs). Methods: This cross-sectional study aimed to determine factors associated with self-reported HH performance among nurses at Kelantan tertiary care hospitals. A sample of 438 registered nurses was selected through a stratified random sampling method. Self-reported HH performance was assessed using a validated WHO self-administered HH knowledge and perception questionnaire for healthcare workers. Results: A multiple linear regression analysis was performed to identify the predictors. The factors that significantly predicted self-reported HH performance among nurses included perception score (beta coefficient (β) = 0.260; 95% CI: 0.200, 0.417; p < 0.001), pediatric department (β = −0.104; 95% CI: −9.335, −2.467; p < 0.001), and orthopedic department (β = −5.957; 95% CI: −9.539, −0.720; p < 0.023), adjusted R2 = 0.102; p < 0.001. Nurses with a strong perception and belief in HH were more likely to have better HH performance. Compared to pediatric and orthopedic, surgical departments were associated with better self-reported HH performance. Conclusions: This study showed the importance of factors that could improve the intervention’s performance in HH strategy. Lack of perception and HH program intervention in departments engaged in patient care could lead to poor HH practices, thus increasing HCAIs and antimicrobial resistance (AMR).

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A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance

Cited by 14 publications

References 24 publications

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Hand hygiene compliance among caregivers of inpatients with multidrug-resistant organism infection in China: a cross-sectional study

Predictors of Self-Reported Hand Hygiene Performance among Nurses at Tertiary Care Hospitals in East Coast Malaysia

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