Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in three cities of Colombia

Barahona-Guzmán, Nayide; Rodríguez-Calderón, Maria E.; Rosenthal, Víctor D.; Olarte, Narda; Villamil-Gómez, Wilmer E.; Rojas, Catherine; Rodríguez-Ferrer, Marena; Sarmiento-Villa, Guillermo; Lagares-Guzmán, Alfredo; Valderrama, Alberto; Menco, A.; Arrieta, P. Pérez Martínez de; Dajud-Cassas, Luis Enrique; Mendoza, Mariela Montilva de; Sabogal, Alejandra; Carvajal, Yulieth; Silva, Edwin

doi:10.1016/j.ijid.2013.10.021

Cited by 23 publications

(8 citation statements)

References 34 publications

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“…In low-income and middle-income countries, HH compliance was averaged 22·4% before multimodal intervention [ 11 ]. Hand hygiene compliance was much lower in the present study compared to post- multimodal intervention studies from India (82%) [ 15 ], Kuwait (61.4%) [ 25 ], and Colombia (77%) [ 26 ]. The possible reason for low compliance in our study might be due to the WHO’s multimodal HH improvement strategy which was not implemented.…”

Section: Discussioncontrasting

confidence: 67%

A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia

Kolola

Gezahegn

2017

Antimicrob Resist Infect Control

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BackgroundHand hygiene (HH) is recognized as the single most effective strategy for preventing health care–associated infections. In developing countries, data on hand hygiene compliance is available only for few health-care facilities. This study aimed to assess hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia.MethodsThis study employed the WHO hand hygiene observation method. Direct observation of the health care workers (HCWs) was conducted using an observation record form in five different wards. Trained and validated observers watched HCWs while they had direct contact with patients or their surroundings, and the observers then recorded all possible hand hygiene opportunities and hand hygiene actions. Observation was conducted over a 24 h period to minimize selection bias. More than 200 opportunities per ward were observed according to WHO recommendation, except in neonatal intensive care unit. HH compliance was calculated by dividing the number of times hand hygiene was performed by the total number of opportunities for hand hygiene. A 95% confidence interval (CI) was computed for compliance with the exact binomial method.ResultsA total of 917 hand hygiene opportunities were observed during the study. Overall HH compliance was 22.0% (95% CI: 19.4–24.9). HH compliance was similar across all professional categories and did not vary by shift. Levels of compliance were lower before patient contact (2.4%; 95% CI: 0.9–5.3), before an aseptic procedure (3.6%; 95% CI: 1.6–7.6) and after contact with patient surroundings (3.3%; 95% CI: 1.2–7.9), whereas better levels of compliance were found after body fluid exposure (75.8%; 95% CI: 68.0–82.3) and after patient contact (42.8%; 95% CI: 35.2–50.7).ConclusionHH compliance of HCWs was found to be low in Debre Berhan referral hospital. Compliance with indications that protect patients from infection was lower than that protect the HCWs. The findings of this study indicate that HH compliance needs further improvement.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-017-0268-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 67%

A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia

Kolola

Gezahegn

2017

Antimicrob Resist Infect Control

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“…Higher compliance was marked after patient contact than that of before patient contact. It matches the pattern frequently revealed by other researchers (Allegranzi et al, 2013;Barahona-Guzmán et al, 2014;Horng et al, 2016;Mahfouz, Al-Zaydani, Abdelaziz, El-Gamal, & Assiri, 2014;Mu et al, 2016;Salama, Jamal, Al Mousa, Al-AbdulGhani, & Rotimi, 2013;Santosaningsih et al, 2017;Uneke et al, 2014). The fear of acquiring infection through patient contact might motivate the HCWs to clean their hands more after touching patients in order to protect themselves (Allegranzi et al, 2013;Randle, Arthur, & Vaughan, 2010).…”

Section: Discussionsupporting

confidence: 85%

Implementation of a Multimodal Multicentre Hand Hygiene Study: Evidence From Bangladesh Hospitals

Ara¹,

Trisha²,

Tamal³

et al. 2019

GJHS

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INTRODUCTION: Hand hygiene (HH), one of the most important preventive measures of Healthcare-associated infections (HCAIs), is often neglected by healthcare workers (HCWs) in low and middle-income countries (LMICs). PURPOSE: The purpose of the study is to assess the role of a multimodal intervention (MMI) for enhancing hand hygiene compliance (HHC) of HCWs in a resource-limited setting. METHODOLOGY: A pretest-posttest quasi-experimental study was conducted in five hospitals of Bangladesh where 984 HCWs (342 physicians and 642 nurses) were selected purposively. Using a structured checklist, a direct observational assessment was carried out on HCWs’ HHC both before and after the intervention. The MMI provided to HCWs comprised of: (i) system change, (ii) educational intervention, (iii) visual reminders, (iv) monitoring and performance feedback and (v) formation of infection control committees. RESULTS: Following intervention, overall HH compliance before and after patient contact significantly increased (p<0.00) to 50.1% and 57.2% respectively across all hospitals, professional categories and activities. Nurses were more compliant to HH than physicians (OR = 1.1, 95% CI: 1.0-1.3, P < 0.01) after patient contacts. However, both groups showed equal HHC (OR = 1, CI: 0.9-1.1, P = 0.72) before patient contacts. HCWs of private hospitals were 1.5 times more compliant to HHC than that of public hospitals. CONCLUSIONS: This study denotes that despite national policies on hand hygiene in Bangladesh, HCW’s compliance to HH is poor. Study findings also illustrate that a multimodal HH program resulted in significant improvement in HCWs’ HHC that deserves the potentials to assist the advancement of infection control practices targeting reduction of HCAIs.

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“…However, hand hygiene is in irregular practice in low-resource settings, historically reported at rates of less than 20%[84–86], though new data now suggest that regular hand cleansing practices may now be on the rise[86–88]. Multidimensional hand hygiene programs incorporating education, observation, feedback and incentives have been shown to at least transiently improve hand hygiene compliance[86].…”

Section: Turning the Tide Of Antimicrobial Resistance: Interventions mentioning

confidence: 99%

Antibiotic Use and Emerging Resistance: How Can Resource-Limited Countries Turn the Tide?

2014

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Antibiotic resistance is a global crisis driven by appropriate and inappropriate antibiotic use to treat human illness and promote animal growth. The antimicrobial resistance epidemic continues to spread due to the triple threat of unfettered access, minimal product regulation and oversight of antibiotic prescription, and lack of clinical diagnostic tools to support antibiotic de-escalation in low-resource settings. In high-resource settings, evidence-based strategies have improved appropriateness of antibiotic use, limiting the spread of drug-resistant organisms and reducing hospital-associated infections, which may also be effective to stop the spread of resistance in resource-poor countries. Current research and surveillance efforts on antimicrobial resistance and hospital-associated infections in low-resource settings are extremely limited, largely focused intensive care units. Many challenges exist to improving antibiotic use and infection control in resource-limited settings, and turning the tide requires intensifying research and surveillance, antimicrobial stewardship, and developing new bedside diagnostic tools for bacterial infections and antimicrobial susceptibility.

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Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in three cities of Colombia

Abstract: Adherence to HH was increased by 55% with the INICC approach. Programs targeted at improving HH in variables found to be predictors of poor compliance should be implemented.

Cited by 23 publications

References 34 publications

A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia

A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia

Implementation of a Multimodal Multicentre Hand Hygiene Study: Evidence From Bangladesh Hospitals

Antibiotic Use and Emerging Resistance: How Can Resource-Limited Countries Turn the Tide?

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