Draft APIC guideline for handwashing and hand antisepsis in health care settings

Larson, Elaine

doi:10.1016/0196-6553(94)90027-2

Cited by 172 publications

(277 citation statements)

References 200 publications

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“…All 12 items were reviewed by an expert panel (n = 8) that consisted of 1 microbiologist, 2 infectiologists, 3 infection control nurses, 1 intensivist, and 1 researcher. As a result, some of the A lthough hand hygiene is the most effective measure to prevent cross-infection and as such limits the deleterious effect of health care-associated infection, [1][2][3][4] overall compliance is unacceptably poor among health care workers. Barriers to appropriate hand hygiene practice have been studied and reported extensively, but even in settings with optimal environmental conditions, compliance appears to range from 50% to 60% at most.…”

Section: Questionnaire Developmentmentioning

confidence: 99%

Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Wandel¹,

Maes²,

Labeau³

et al. 2010

American Journal of Critical Care

134

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Background Although hand hygiene is the most effective measure for preventing cross-infection, overall compliance is poor among health care workers. Objectives To identify and describe predictors and determinants of noncompliance with hand hygiene prescriptions in intensive care unit nurses by means of a questionnaire. Methods A questionnaire based on a behavioral theory model was filled out by 148 nurses working on a 40-bed intensive care unit in a university hospital. Subjects were asked to fill out the 56-item questionnaire twice within a 2-to 6-week period. During this period, no interventions to enforce hand hygiene occurred on the unit. Results Response rate for the test was 73% (108/148); response rate for the retest was 53% (57/108). The mean self-reported compliance rate was 84%. Factor analysis revealed 8 elementary factors potentially associated with compliance. Internal consistency of the scales was acceptable. Intraclass correlation was low (<0.60) for 2 subscales but acceptable (>0.60) for 6 subscales. A low self-efficacy was independently associated with noncompliance (β = .379; P = .001). After exclusion of this variable, a negative attitude toward time-related barriers was associated with noncompliance (β = -.147; P < .001). Conclusions Neither having good theoretical knowledge of hand hygiene guidelines nor social influence or moral perceptions had any predictive value relative to hand hygiene practice. A valid questionnaire to identify predictors and determinants of noncompliance with hand hygiene has been designed. Nurses reporting a poor self-efficacy or a poor attitude toward time-related barriers appear to be less compliant. (American Journal of Critical Care. 2010;19:230-240) BEHAVIORAL DETERMINANTS OF HAND HYGIENE COMPLIANCE IN INTENSIVE CARE UNITS C E 1.0 Hour Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Recognize the impact of behavioral determinants on compliance with hand hygiene recommendations. 2. Describe determinants of noncompliance with hand hygiene prescriptions among nurses in a general intensive care unit. 3. Understand how a low self-efficacy and a negative attitude toward time-related barriers are predictors of poor compliance with hand hygiene recommendations. In accordance with the attitude-social influenceself-efficacy model, 12 which combines Fishbein and Ajzen's theory of reasoned action 13 and Bandura's social learning theory, 14 attitude, social influence, and self-efficacy are valid concepts in predicting one's intention to change one's behavior or even one's actual change in behavior. 15,16 Attitude is primordially based on earlier experiences: behavior that has led to success will be reinforced and vice versa. Although one's general attitude toward a certain behavior is often the result of success and failure (or perceived advantage and disadvantage), not all attitudes are based on reason and logical sense. Some attitudes can be very rigid and based on highly ...

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Section: Questionnaire Developmentmentioning

confidence: 99%

Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Wandel¹,

Maes²,

Labeau³

et al. 2010

American Journal of Critical Care

134

View full text Add to dashboard Cite

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“…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.…”

mentioning

confidence: 99%

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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“…Opportunities for hand hygiene were defined as situations in which published guidelines available when the study was performed recommended performance of hand hygiene. 9 Compliance with hand hygiene guidelines was defined as washing hands with soap and water or rubbing hands with an antiseptic solution.…”

Section: E T H O D Smentioning

confidence: 99%

Hand Hygiene and Glove Use Behavior in an Italian Hospital

Pan

Mondello

Posfay‐Barbe³

et al. 2007

Infect. Control Hosp. Epidemiol.

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In an Italian hospital, we observed that hand hygiene was performed in 638 (19.6%) of 3,253 opportunities, whereas gloves were worn in 538 (44.2%) 1,218 of opportunities. We observed an inverse correlation between the intensity of care and the rate of hand hygiene compliance (R 2 = 0.057; P< .001), but no such association was observed for the rate of glove use compliance (R 2 = 0.014; P = .078). Rates of compliance with hand hygiene and glove use recommendations follow different behavioral patterns. Infect Control Hosp Epidemiol

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Draft APIC guideline for handwashing and hand antisepsis in health care settings

Cited by 172 publications

References 200 publications

Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

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

Hand Hygiene and Glove Use Behavior in an Italian Hospital

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