Abstract
BackgroundWorkers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Therefore, a multifaceted implementation strategy (MIS) is developed to implement these recommendations to reduce hand eczema among health care workers performing wet work.Methods/DesignThis study is a randomised controlled trial in three university hospitals in the Netherlands. Randomisation to the control or intervention group is performed at department level. The control group receives a leaflet containing the recommendations only. The intervention group receives the MIS which consists of five parts: 1) within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2) role models will help their colleagues in performing the desired behaviour; 3) education to all workers will enhance knowledge about (the prevention of) hand eczema; 4) reminders will be placed at the department reminding workers to use the recommendations; 5) workers receive the same leaflet as the control group containing the recommendations. Data are collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure is self-reported hand eczema. The most important secondary outcome measures are symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and health care costs.Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employer's perspective.DiscussionThe prevention of hand eczema is important for the hospital environment. If the MIS has proven to be effective, a major improvement in the health of health care workers can be obtained. Results are expected in 2014.Trial registration numberNTR2812
Highlights
Workers in wet work occupations have a risk for developing hand eczema
The prevention of hand eczema is important for the hospital environment
Workers of the department allocated to the intervention group will receive the multifaceted implementation strategy (MIS); departments allocated to the control group will receive usual practice
Summary
Occupational skin diseases are considered to be in the top-3 of work-related disorders in Europe [1]. The high prevalence of hand eczema among health care workers - nurses, cleaners, food handlers, workers in the laboratory - and the related cost for society indicate that prevention of hand eczema is needed. For this purpose the Dutch Board for Occupational Medicine (NVAB) developed an evidence based guideline to reduce occupational hand eczema [19]. The proposed implementation strategies have proven their effectiveness, there are no studies on hand eczema using senior role models and participatory working groups for health care workers on a large scale. Secondary objectives are: 1) to compare effectiveness of the multifaceted strategy on adherence to the recommendations, general health status of the hands, sick leave and work productivity, and 2) to evaluate the cost-effectiveness of the multifaceted implementation strategy compared to usual practice
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