Abstract
A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.
Highlights
In recent years, increasing attention has been given to hand hygiene as a leading measure to prevent the spread of antimicrobial resistance and to reduce healthcare-associated infections (HAIs) [1]
This study reports the campaign’s effect on hand hygiene compliance immediately after implementation, and identifies factors associated with the observed improvement at the individual level and at the ward level
Implementation of a multimodal promotion campaign in 65 hospitals at the national level in Italy led to significant hand hygiene compliance improvement across all types of wards and professional categories
Summary
In recent years, increasing attention has been given to hand hygiene as a leading measure to prevent the spread of antimicrobial resistance and to reduce healthcare-associated infections (HAIs) [1]. Several studies offer convincing evidence that improved hand hygiene practices lead to a reduction of HAIs and/or transmission or colonisation by multidrug-resistant organisms (MDROs) [2]. In October 2005, the World Health Organization (WHO) launched Clean Care is Safer Care, a global hand hygiene campaign [3]. Aimed to reduce HAIs it focused on implementing new hand hygiene recommendations [4] through a multimodal hand hygiene promotion campaign [5]. The multimodal national campaign was conducted in 2007–2008 and not repeated in the following years
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