Abstract
BackgroundHand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcare-associated infections. In 2007, a voluntary national electronic surveillance tool for the documentation of consumption of alcohol-based hand rub (AHC) was introduced as a surrogate for hand hygiene compliance (HAND-KISS) and for the provision of benchmark data as feedback.The aim of the study was to determine the trend in alcohol-based hand rub consumption between 2007 and 2018.Materials and methodsIn this cohort study, AHC and patient days (PD) were documented on every ward in participating hospitals by trained local staff. Data was collected and validated in HAND-KISS. Intensive care units (ICU), intermediate care units (IMC), and regular wards (RW) that provided data during the study period between 2007 until 2018 were included into the study.ResultsIn 2018, 75.2% of acute care hospitals in Germany (n = 1.460) participated. On ICUs (n = 1998) mean AHC increased 1.74 fold (95%CI 1.71, 1.76; p < .0001) from 79.2 ml/PD to 137.4 ml/PD. On IMCs (n = 475) AHC increased 1.69 fold (95%CI 1.60, 1.79; p < .0001) from 41.4 ml/PD to 70.6 ml /PD..On RWs (n = 14,857) AHC was 19.0 ml/PD in 2007 and increased 1.71 fold (95%CI 1.70, 1.73; p < .0001) to 32.6 ml/PD in 2018.ConclusionsAHC in German hospitals increased on all types of wards during the past 12 years. Surveillance of AHC is widely established in German hospitals. Large differences among medical specialties exist and warrant further investigation.
Highlights
Hand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcareassociated infections
On intermediate care units (IMC) (n = 475) alcohol-based hand rub consumption (AHC) increased 1.69 fold (95%95% Confidence interval (CI) 1.60, 1.79; p < .0001) from 41.4 ml/patient days (PD) to 70.6 ml /PD..On regular wards (RW) (n = 14,857) AHC was 19.0 ml/PD in 2007 and increased 1.71 fold (95%CI 1.70, 1.73; p < .0001) to 32.6 ml/PD in 2018
Median AHC increased from 70.6 ml/PD (IQR: 52.5– 97.74) to 129.4 ml/PD (IQR: 102.5–160.9) on Intensive care units (ICU) (1.74 fold; 95%CI 1.71, 1.76; p < .0001)
Summary
Hand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcareassociated infections. In overt observations improved compliance with hand hygiene can be occur in health care workers [6, 7] This approach is time and resource intensive and might be difficult to implement in some centers [8]. While some reports describe a correlation with compliance on non-ICU inpatient wards [11, 12], others find no correlation between AHC and directly observed compliance [10]. It provides opportunities for benchmarking and for additional feedback which is a key strategy for the improvement of hand hygiene compliance [13, 14]
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