Occurrence of infectious symptoms in children in day care homes

Butz, Arlene; Larson, Elaine; Fosarelli, Patricia; Yolken, Robert H.

doi:10.1016/0196-6553(90)90248-q

Cited by 74 publications

(53 citation statements)

References 17 publications

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“…2 " 8 Despite study limitations, most reports showed a temporal relation between improved hand-hygiene practices and reduced infection rates. Similarly, the beneficial effects of hand-hygiene promotion on the risk of crosstransmission have been reported in surveys conducted in schools or day-care centers, 9 " 12 as well as in a community setting. 1315 Despite such evidence, studies in the literature have repeatedly documented that the importance of this simple procedure is not sufficiently recognized by healthcare workers (HCWs), 16 and compliance with recommended hand-hygiene practices is unacceptably low.…”

mentioning

confidence: 74%

Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

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Hand hygiene prevents cross-infection in hospitals, but compliance with recommended instructions often is poor among healthcare workers. Although some previous interventions to improve compliance have been successful, none has achieved lasting improvement. This article reviews reported barriers to appropriate hand hygiene and factors associated with poor compliance.Easy access to hand hygiene in a timely fashion and the availability of skin-care lotion both appear to be necessary prerequisites for appropriate hand-hygiene behavior. In particular, in high-demand situations, hand rub with an alcohol-based solution appears to be the only alternative that allows a decent compliance. The hand-hygiene compliance level does not rely on individual factors alone, and the same can be said for its promotion. Because of the complexity of the process of change, it is not surprising that solo interventions often fail, and multimodal, multidisciplinary strategies are necessary. A framework that includes parameters to be considered for hand-hygiene promotion is proposed, based on epidemiologically driven evidence and review of the current knowledge. Strategies for promotion in hospitals should include reasons for noncompliance with recommendations at individual, group, and institutional levels. Potential tools for change should address each of these elements and consider their interactivity {Infect Control Hosp Epidemiol 2000;21:381-386).Hand hygiene is considered the most important measure to reduce the transmission of nosocomial pathogens in healthcare settings. As recently reviewed by Larson in a comprehensive article, 1 seven quasi-experimental hospitalbased studies of the impact of hand hygiene on the risk of nosocomial infection have been published between 1977 and 1995. 2 " 8 Despite study limitations, most reports showed a temporal relation between improved hand-hygiene practices and reduced infection rates. Similarly, the beneficial effects of hand-hygiene promotion on the risk of crosstransmission have been reported in surveys conducted in schools or day-care centers, 9 " 12 as well as in a community setting. 1315 Despite such evidence, studies in the literature have repeatedly documented that the importance of this simple procedure is not sufficiently recognized by healthcare workers (HCWs), 16 and compliance with recommended hand-hygiene practices is unacceptably low. 8,16 " 21 This article reviews factors that may explain the lack of adherence by HCWs to hand-hygiene procedures and suggests strategies for promotion in hospitals.

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mentioning

confidence: 74%

Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

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“…We also excluded studies that examined the effect of multicomponent hygiene interventions, for example, disinfecting surfaces as well as hands and toys [34][35][36][37] as it was difficult to isolate the relative effect of hand hygiene from among these interventions. None of these earlier studies examined the effect of influenza specifically.…”

Section: Laboratory-con Irmed In Luenza Outcomesmentioning

confidence: 99%

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Warren‐Gash

Fragaszy

Hayward

2012

Influenza Resp Viruses

106

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Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low-quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower-middle-income setting. There was high-quality evidence of a small reduction in respiratory infection in childcare settings. There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate-to highquality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.

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“…890 In several other studies in which hand hygiene compliance was not monitored, multidisciplinary programmes that involved the introduction of an alcohol-based handrub were associated with a decrease in HCAI and cross-transmission rates. 429,489,645,735 The beneficial effects of hand hygiene promotion on the risk of cross-transmission have also been reported in surveys conducted in schools or day-care centres, 454,[891][892][893][894][895][896] as well as in community settings. 248,249,449,754,815,830,[897][898][899][900] While none of the studies conducted in the health-care setting represented randomized controlled trials, they provide substantial evidence that increased hand hygiene compliance is associated with reduced HCAI rates.…”

Section: Impact Of Improved Hand Hygienementioning

confidence: 95%