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A multimodal intervention to improve hand hygiene compliance in a tertiary care center.
Am J Infect Control. 2018 07; 46(7):775-780.AJ

Abstract

BACKGROUND

Healthcare-associated infections (HAIs) are a major threat to patient safety worldwide. HAIs are mainly transmitted via the hands of healthcare workers (HCWs), and HCW compliance with hand hygiene (HH) practices is reportedly low. Therefore, multimodal interventions are needed to develop effective HH improvement strategies. In this study, we assessed the effect of multimodal interventions on improvement of HH compliance.

METHODS

This study was conducted in 2 intensive care units from August 2016 to October 2016. It encompassed 3 phases: pre-intervention (20 days), intervention (1 month), and post-intervention (20 days). A total of 53 HCWs, including physicians, nurses, and housekeeping staff, were included in the HH audit. The audit was analyzed by direct observation and by a completed knowledge, attitude, and practice (KAP) questionnaire.

RESULTS

A total of 6350 HH opportunities were recorded; the results were 34.7%, 35%, and 69.7% for hand hygiene complete adherence rate (HHCAR), hand hygiene partial adherence rate (HHPAR), and hand hygiene adherence rate (HHAR), respectively. The HHCAR in the pre-intervention and post-intervention phases were 3% and 70.1%, respectively. HHCAR was highest among nurses (3.6% in the pre-intervention phase and 80.7% in the post-intervention phase). Other findings were that senior physicians had better HH compliance than junior physicians; in the pre-intervention phase, the HHCAR was better in the evening (4.8%); in the post-intervention phase, the HHCAR was better in the morning (72.1%); women had a higher HHCAR than men; and in the pre-intervention phase, good compliance was seen with Moments 2 and 3 of the World Health Organization's (WHO) Five Moments for Hand Hygiene, whereas in the post-intervention phase, good compliance was seen with Moments 3, 4, and 5. Questionnaire-based data were also analyzed to assess KAP of HH. We found that only 55%-82% of HCWs were aware of the WHO's Five Moments for Hand Hygiene. In the post-intervention phase, we observed a significant improvement in KAP of the study group.

CONCLUSION

Significant improvement in HH compliance can be achieved through a systematic, multidimensional intervention involving all types of HCWs.

Authors+Show Affiliations

Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India. Electronic address: rapurbasastry@gmail.com.Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29753498

Citation

Laskar, Abdul Mannan, et al. "A Multimodal Intervention to Improve Hand Hygiene Compliance in a Tertiary Care Center." American Journal of Infection Control, vol. 46, no. 7, 2018, pp. 775-780.
Laskar AM, R D, Bhat P, et al. A multimodal intervention to improve hand hygiene compliance in a tertiary care center. Am J Infect Control. 2018;46(7):775-780.
Laskar, A. M., R, D., Bhat, P., Pottakkat, B., Narayan, S., Sastry, A. S., & Sneha, R. (2018). A multimodal intervention to improve hand hygiene compliance in a tertiary care center. American Journal of Infection Control, 46(7), 775-780. https://doi.org/10.1016/j.ajic.2017.12.017
Laskar AM, et al. A Multimodal Intervention to Improve Hand Hygiene Compliance in a Tertiary Care Center. Am J Infect Control. 2018;46(7):775-780. PubMed PMID: 29753498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multimodal intervention to improve hand hygiene compliance in a tertiary care center. AU - Laskar,Abdul Mannan, AU - R,Deepashree, AU - Bhat,Prasanna, AU - Pottakkat,Biju, AU - Narayan,Sunil, AU - Sastry,Apurba Sankar, AU - Sneha,R, Y1 - 2018/05/09/ PY - 2017/08/07/received PY - 2017/12/21/revised PY - 2017/12/21/accepted PY - 2018/5/14/pubmed PY - 2019/9/24/medline PY - 2018/5/14/entrez KW - Audit KW - Hand hygiene KW - Hand hygiene adherence rate (HHAR) KW - Knowledge, attitude, and practice SP - 775 EP - 780 JF - American journal of infection control JO - Am J Infect Control VL - 46 IS - 7 N2 - BACKGROUND: Healthcare-associated infections (HAIs) are a major threat to patient safety worldwide. HAIs are mainly transmitted via the hands of healthcare workers (HCWs), and HCW compliance with hand hygiene (HH) practices is reportedly low. Therefore, multimodal interventions are needed to develop effective HH improvement strategies. In this study, we assessed the effect of multimodal interventions on improvement of HH compliance. METHODS: This study was conducted in 2 intensive care units from August 2016 to October 2016. It encompassed 3 phases: pre-intervention (20 days), intervention (1 month), and post-intervention (20 days). A total of 53 HCWs, including physicians, nurses, and housekeeping staff, were included in the HH audit. The audit was analyzed by direct observation and by a completed knowledge, attitude, and practice (KAP) questionnaire. RESULTS: A total of 6350 HH opportunities were recorded; the results were 34.7%, 35%, and 69.7% for hand hygiene complete adherence rate (HHCAR), hand hygiene partial adherence rate (HHPAR), and hand hygiene adherence rate (HHAR), respectively. The HHCAR in the pre-intervention and post-intervention phases were 3% and 70.1%, respectively. HHCAR was highest among nurses (3.6% in the pre-intervention phase and 80.7% in the post-intervention phase). Other findings were that senior physicians had better HH compliance than junior physicians; in the pre-intervention phase, the HHCAR was better in the evening (4.8%); in the post-intervention phase, the HHCAR was better in the morning (72.1%); women had a higher HHCAR than men; and in the pre-intervention phase, good compliance was seen with Moments 2 and 3 of the World Health Organization's (WHO) Five Moments for Hand Hygiene, whereas in the post-intervention phase, good compliance was seen with Moments 3, 4, and 5. Questionnaire-based data were also analyzed to assess KAP of HH. We found that only 55%-82% of HCWs were aware of the WHO's Five Moments for Hand Hygiene. In the post-intervention phase, we observed a significant improvement in KAP of the study group. CONCLUSION: Significant improvement in HH compliance can be achieved through a systematic, multidimensional intervention involving all types of HCWs. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/29753498/A_multimodal_intervention_to_improve_hand_hygiene_compliance_in_a_tertiary_care_center L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(17)31358-5 DB - PRIME DP - Unbound Medicine ER -