Impact of psychologically tailored hand hygiene interventions on nosocomial infections with multidrug-resistant organisms: results of the cluster-randomized controlled trial PSYGIENE

Lengerke, Thomas von; Ebadi, Ella; Schock, Bettina; Krauth, Christian; Lange, Karin; Stahmeyer, Jona T.; Chaberny, Iris F.

doi:10.1186/s13756-019-0507-5

Cited by 37 publications

(58 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We observed significantly lower rates of device-associated BSIs in the intervention group when compared to the control group, similar to other studies that have demonstrated a reduction in HAI rates due to improved HH [ 27 – 29 ]. Despite a focus on PVCs in our teaching materials, this difference was mainly due to a lower rate of CVC-associated BSIs.…”

Section: Discussionsupporting

confidence: 90%

A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial

Aghdassi

Schröder

Lemke

et al. 2020

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Interventions to improve hand hygiene (HH) compliance are a key element in the practice infection prevention and control. It was our objective to assess the effect of a multimodal intervention on HH compliance at a tertiary care university hospital. As a secondary objective, we investigated the effect of the intervention on the occurrence of device-associated bloodstream infections. Methods We performed a single centre cluster randomised controlled trial at a university hospital in Germany. Twenty peripheral wards were invited to participate and randomly assigned to either the intervention ( n = 10) or control group ( n = 10). Quarterly, specifically trained student employees conducted direct compliance observations in all twenty wards. The intervention entailed dissemination of teaching materials on aseptic procedures, equipment with flexibly mountable alcoholic hand rub dispensers, and quarterly feedback on HH compliance. Results In total, 21,424 HH opportunities were observed. Overall, compliance did not change significantly in either group (intervention group: 59% vs. 61% (1482 HH actions for 2494 HH opportunities vs. 5033 HH actions for 8215 HH opportunities), odds ratio (OR) 1.08 (95% confidence interval (CI95) 0.88, 1.33)); control group: 59% vs. 60% (1457 HH actions for 2484 HH opportunities vs. 4948 HH actions for 8231 HH opportunities), OR 1.06 (CI95 0.84, 1.35)). Compliance prior to aseptic procedures improved significantly in the intervention group from 44% (168 HH actions for 380 HH opportunities) to 53% (764 HH actions for 1452 HH opportunities) (OR 1.40 (CI95 1.04, 1.89), p = 0.03), while no significant increase was noted in the control group. In the intervention group, significantly fewer device-associated bloodstream infections per 1000 patient-days occurred than in the control group (84 vs. 123, incidence rate ratio 0.61 (CI95 0.46, 0.81), p < 0.01). Conclusions The lack of a significant overall improvement of HH compliance demonstrated that comprehensive implementation of HH interventions in multiple wards simultaneously is difficult. However, through targeted intervention measures, we were able to significantly increase HH compliance before aseptic procedures.

show abstract

Section: Discussionsupporting

confidence: 90%

A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial

Aghdassi

Schröder

Lemke

et al. 2020

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…The best way to achieve this is multifocal teaching with mixed methodologies, because it is not completely clear which teaching methods are better than others [52]. However, some systematic reviews have shown that tailored interventions addressing the determinants of practice improve hand hygiene compliance [53,54].…”

Section: Discussionmentioning

confidence: 99%

Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review

Martos-Cabrera

Mota-Romero

Martos-García

et al. 2019

IJERPH

View full text Add to dashboard Cite

Background: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct adherence and perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with consequent complications. The aim here was to analyze hand hygiene training and the effectiveness of different methods and educational strategies among nurses and whether they maintained correct adherence over time. Methods: A systematic review was conducted in the sources CINAHL (Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline, SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject Headings (MeSH) descriptors was “Nurs* AND (handwashing OR hand hygiene) AND clinical trial”. The review was performed following the recommendations of the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: n = 17 clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as reminder sounds, practical simulations, videos, and audiovisual media improved handwashing compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the use of povidone–iodine, which reduced colony formation compared Hand hygiene teaching strategies among nursing staff: a systematic review to soap. Conclusions: The strategies that go beyond teaching techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility, and repetition.

show abstract

“…Among the other interventions least used (i.e., in below 10% of the studies), tailored interventions, which have, e.g., been shown to be especially effective in promoting hand hygiene compliance and lead to larger reductions in MRE-infections than non-tailored ones [77,78], are particularly noteworthy. Baker and colleagues defined tailored interventions as "… strategies to improve professional practice that are planned, taking account of prospectively identified determinants of practice" [79] (p. 5).…”

Section: Discussionmentioning

confidence: 99%

Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review

Tomsic

Heinze

Chaberny

et al. 2020

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background: Surgical site infections (SSIs) are highly prevalent in abdominal surgery despite evidence-based prevention measures. Since guidelines are not self-implementing and SSI-preventive compliance is often insufficient, implementation interventions have been developed to promote compliance. This systematic review aims to identify implementation interventions used in abdominal surgery to prevent SSIs and determine associations with SSI reductions. Methods: Literature was searched in April 2018 (Medline/PubMed and Web of Science Core Collection). Implementation interventions were classified using the implementation subcategories of the EPOC Taxonomy (Cochrane Review Group Effective Practice and Organisation of Care, EPOC). Additionally, an effectiveness analysis was conducted on the association between the number of implementation interventions, specific compositions thereof, and absolute and relative SSI risk reductions. Results: Forty studies were included. Implementation interventions used most frequently ("top five") were audit and feedback (80% of studies), organizational culture (70%), monitoring the performance of healthcare delivery (65%), reminders (53%), and educational meetings (45%). Twenty-nine studies (72.5%) used a multimodal strategy (≥3 interventions). An effectiveness analysis revealed significant absolute and relative SSI risk reductions. E.g., numerically, the largest absolute risk reduction of 10.8% pertained to thirteen studies using 3-5 interventions (p < .001); however, this was from a higher baseline rate than those with fewer or more interventions. The largest relative risk reduction was 52.4% for studies employing the top five interventions, compared to 43.1% for those not including these. Furthermore, neither the differences in risk reduction between studies with different numbers of implementation interventions (bundle size) nor between studies including the top five interventions (vs. not) were significant.

show abstract

Impact of psychologically tailored hand hygiene interventions on nosocomial infections with multidrug-resistant organisms: results of the cluster-randomized controlled trial PSYGIENE

Cited by 37 publications

References 50 publications

A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial

A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial

Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review

Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review

Contact Info

Product

Resources

About