Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Sakihama, Tomoko; Kayauchi, Naomi; Kamiya, Toru; Saint, Sanjay; Fowler, Karen E.; Ratz, David; Sato, Yumiko; Iuchi, Ritsuko; Honda, Hitoshi; Tokuda, Yasuharu

doi:10.1016/j.ajic.2019.06.017

Cited by 12 publications

(9 citation statements)

References 23 publications

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“…We found an increase in HH compliance by 5 moments across all healthcare workers and unit types with implementation of multimodal HH interventions, similar to findings of previous reports [15,18,19]. Comparing other moments and healthcare workers, HH compliance was generally lower for before touching a patient and after contact with patient surroundings, while compliance was lower among interns and cleaners.…”

Section: Discussionsupporting

confidence: 89%

Effects of a 4-year intervention on hand hygiene compliance and incidence of healthcare associated infections: a longitudinal study

et al. 2021

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Purpose Studies have demonstrated improvements in hand hygiene (HH) compliance through interventions, noting the negative association of HH and healthcare associated infections (HAIs), but how to sustain long-term improvement is still unknown in the Chinese population. This study sought to determine the extent of change in HH compliance after multimodal HH interventions, and to evaluate the relationship between that change and HAI incidence. Methods We conducted a longitudinal study in a general teaching hospital in China from 2017 to 2020. Trained investigators observed HH practices based on the World Health Organization's 5 moments for HH. We identified the incidence of HAIs using semi-automated constant surveillance software. We used the Cochran-Mantel-Haenszel test to assess the secular trend of HH compliance and HAIs. The Spearman correlation coefficient (r s ) was used to evaluate the relationship between the incidence of HAIs and compliance with HH. Results The study made 480,943 observations, where HH was occurring between 2017 and 2020. HH compliance increased from 68.90 to 91.76% during that period (P trend < 0.01), while the incidence of HAIs decreased from 1.10 to 0.91%. Compliance also increased for each moment type and for each healthcare worker (P trend < 0.01). Lower HH compliance was observed in before-patient contact and after contact with patient surroundings, and among interns and cleaners. We also observed a weak but statistically significant negative correlation between the monthly HH compliance and incidence of HAIs (r s = − 0.27; P = 0.037). Conclusions The multimodal HH implementation delivered sustained improvement in HH compliance, and this change was associated with a decline in the incidence of HAIs.

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Section: Discussionsupporting

confidence: 89%

Effects of a 4-year intervention on hand hygiene compliance and incidence of healthcare associated infections: a longitudinal study

et al. 2021

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“…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. Our primary strategy to mitigate these concerns was to provide personalized coaching by accompanying staff members on their rounds while showing them their data in real time.…”

Section: Discussionmentioning

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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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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“…We expected that both would increase as a result of the initiative but did not expect that the 2 variables would show such a strong correlation. A prior study from Japan [41] suggested that compliance would be improved by increasing the HHSAF score. In this study, the HH compliance rate obtained by direct observation and the HHSAF scores were compared between 3 Japanese hospitals; they ranked in the same order for both measurements.…”

Section: Discussionmentioning

confidence: 99%

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

Suzuki

Morino²,

Morita

et al. 2020

Antimicrob Resist Infect Control

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Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score. Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson's correlation coefficients. Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01). Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

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Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Cited by 12 publications

References 23 publications

Effects of a 4-year intervention on hand hygiene compliance and incidence of healthcare associated infections: a longitudinal study

Effects of a 4-year intervention on hand hygiene compliance and incidence of healthcare associated infections: a longitudinal study

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

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

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