Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department

Arntz, P.R.; Hopman, Joost; Nillesen, M.; Yalçin, Esra; Bleeker‐Rovers, Chantal P.; Voß, Andreas; Edwards, Michael J.; Wei, Anna

doi:10.1016/j.ajic.2016.03.017

Cited by 29 publications

(36 citation statements)

References 21 publications

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“…Promotion of hand hygiene compliance through multimodal strategies has been proven to reduce healthcare-associated infection [60]. Multifaceted interventions such as WHO-5 strategies (including system change, training and education, monitoring and feedback, reminder and communication, and culture of safety) are generally effective in increasing and sustaining hand hygiene compliance at various settings [61][62][63][64][65]. The same evidence has been reported from studies on LTCFs, suggesting improved hand hygiene reduces the infection rate or respiratory outbreaks [66,67].…”

Section: Discussionmentioning

confidence: 84%

A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control

Lee

et al. 2020

PLoS ONE

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BackgroundThe unique characteristics of long-term care facilities (LTCFs) including host factors and living conditions contribute to the spread of contagious pathogens. Control measures are essential to interrupt the transmission and to manage outbreaks effectively. AimThe aim of this systematic review was to verify the causes and problems contributing to transmission and to identify control measures during outbreaks in LTCFs.

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Section: Discussionmentioning

confidence: 84%

A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control

Lee

et al. 2020

PLoS ONE

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“…2,4-7 However, a misalignment was identified between some actions and scientific evidence. [13][14] Hand hygiene practices were not performed by the nurses of the present study at all times, 19 with this action being influenced by the absence of lavatories in the rooms. Other reasons for the non-adherence of hand hygiene are highlighted in the literature, such as lack of time due to work overload and lack of knowledge about clinical situations to carry out hygiene with soap and water or antiseptics.…”

Section: Discussionmentioning

confidence: 84%

“…Other reasons for the non-adherence of hand hygiene are highlighted in the literature, such as lack of time due to work overload and lack of knowledge about clinical situations to carry out hygiene with soap and water or antiseptics. [19][20] In order to provide care in relation to hand hygiene, it is necessary to supervise the adoption of these practices and invest in training, in addition to providing materials and adjusting the infrastructure which is sometimes old or outdated such as rooms without washbasins. [20][21] The absence of disposable tourniquets or cleaning and disinfection of the tourniquets between contact with patients during peripheral venous puncture was a practice among nurses and was corroborated in another study.…”

Section: Discussionmentioning

confidence: 99%

Nursing Practices in Peripheral Venous Catheter: Phlebitis and Patient Safety

Salgueiro-Oliveira

Basto

Braga

et al. 2019

Texto contexto - enferm.

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Objective: to understand the nursing practices related to peripheral venous catheter and to identify deviations related to the scientific evidence regarding the prevention of phlebitis. Method: qualitative study with data collection by means of participant observation techniques and semistructured interviews, with 26 and 15 nurses, respectively, from a Portuguese hospital. Data content analysis was performed. Results: In the category "nursing actions", nursing practices related to: selection of catheter insertion site and its caliber size, evaluation of insertion site for signs of inflammation, insertion site dressing, disinfection of accessories, hand hygiene and patient participation in care emerged. There were situations of deviations in these practices in relation to scientific evidence. Conclusion: Nursing practices presented deviations in relation to scientific evidence, and were influenced by the size of the institution, patient characteristics, and lack of knowledge of nurses regarding certain actions that pose a risk to patient safety. The creation of protocols and the implementation of continuous education are fundamental for the acquisition of competencies by nurses, for correcting deviations and providing a safe quality nursing care to the patient. RESUMOObjetivo: conhecer as práticas de enfermagem relacionadas com o cateterismo venoso periférico e identificar desvios relativos às evidências científicas no que diz respeito à prevenção de flebite. Método: estudo qualitativo com coleta de dados através das técnicas de observação participante e entrevista semiestruturada, com 26 e 15 enfermeiros, respectivamente, de um hospital Português. Foi realizada análise de conteúdo dos dados. Resultados: na categoria Ações de enfermagem, emergiram práticas de enfermagem relacionadas com: seleção do local de inserção do cateter e seu calibre, avaliação do local de inserção quanto aos sinais inflamatórios, curativo na inserção, desinfecção de acessórios, higienização das mãos e participação do doente nos cuidados. Verificaram-se situações de desvios nessas práticas em relação às evidências científicas. Conclusão: as práticas de enfermagem apresentavam desvios em relação às evidências científicas, sendo influenciadas por dimensões institucionais, características dos doentes, e desconhecimento dos enfermeiros acerca de determinadas ações que colocam em risco a segurança do doente. A elaboração de protocolos e a implementação da Educação Continuada são fundamentais para a aquisição de competências pelos enfermeiros, para correção dos desvios e prestação de uma assistência de enfermagem segura e com qualidade para o doente.DESCRITORES: Cateterismo periférico. Dispositivos de acesso vascular. Cuidados de enfermagem. Enfermagem. Flebite. Segurança do paciente. PRÁTICAS DE ENFERMERÍA EN EL CATETERISMO VENOSO PERIFÉRICO: LA FLEBITE Y LA SEGURIDAD DEL PACIENTE RESUMENObjetivo: conocer las prácticas de enfermería relacionadas con el cateterismo venoso periférico e identificar desvíos relativos a las evidencias científicas en ...

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“…In the literature, primarily regarding hospital care, moment 4 generally has the highest compliance, followed by moment 3. [29][30][31][32][33][34][35][36][37][38] These are both moments after an HH-indicated activity. These moments may be prioritized because the healthcare provider wants to protect himself or herself.…”

Section: Discussionmentioning

confidence: 99%

Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

Teesing

Erasmus

Nieboer

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes. Design, setting, and participants: HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded. Intervention: Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty. Results: HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%). Conclusions: The HANDSOME intervention is successful in improving HHC in nursing homes.

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Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department

Cited by 29 publications

References 21 publications

A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control

A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control

Nursing Practices in Peripheral Venous Catheter: Phlebitis and Patient Safety

Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

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