Interventions to improve healthcare workers’ hand hygiene compliance: A systematic review of systematic reviews

Abstract

ObjectiveTo synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).MethodsPRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.ResultsOverall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.ConclusionsThis is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.

AEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic

“… 46 , 47 The implementation of programmes that ensure correct hand hygiene practices improves the efficacy of these measures, and should therefore be guaranteed in all EUs. 48 Changing out of work uniform at the end of each shift and showering prior to leaving the hospital are basic hygiene measures that are recommended by the European Centre for Disease Prevention and Control (ECDC). 49…”

Hand Hygiene during the Early Neonatal Period: A Mixed-methods Observational Study in Healthcare Facilities and Households in Rural Cambodia

“…Adequate hand hygiene through hygienic births and clean post-natal care is the cornerstone of the WHO recommended strategies to prevent infectionrelated newborn death [5,7]. However, despite the implementation of various hand hygiene promotion strategies in healthcare facilities (HCF) [8,9], hand hygiene compliance by both health care workers, parental and other caregivers during birth and post-natal care [10,11] remains low.…”

Hand Hygiene During Facility-Based Childbirth in Cambodia: A Theory-Driven, Mixed-Methods Observational Study

“…Globally, 10% of maternal deaths (8) and 11-19 % of neonatal deaths (9) have been attributed to infections, most of which are acquired during labour, delivery and the rst week of a newborn's life (8,10,11). Despite the implementation of various hand hygiene promotion strategies in healthcare facilities (HCF) (12,13), hand hygiene compliance in both maternal (14) and newborn care (15)(16)(17) remains low.…”

“…Hand hygiene is a behaviour in uenced by multiple factors (4,18) and interventions to improve hand hygiene behaviours are more effective when they target the context-and behaviour-speci c determinants of hand hygiene outcomes (19)(20)(21). However, the current understanding of the drivers of hand hygiene behaviours speci c to labour and delivery is limited (12,13). Hand hygiene improvement strategies targeting HCW often result in small or moderate effects (12,22) and are often only short-term (13,23).…”