The search for an evidence-based intervention to improve hand hygiene compliance in a residential aged care facility

Abstract

Healthcare-acquired infections are a major source of morbidity and mortality in people living in residential aged care facilities. Compliance with hand hygiene by healthcare workers can reduce the risk of infection to residents, yet compliance rates are generally low. Infection-control advocates within the aged care sector are looking to conduct programs to improve rates among their staff. This review was conducted to identify a reproducible intervention to improve staff hand hygiene compliance within an Australian residential aged care facility. Medline, Embase, and CINAHL databases were searched for combinations of ‘hand hygiene’, ‘hand washing’, ‘residential aged care facility’, ‘aged care’, ‘nursing home’ and ‘long-term care facility’ from 2000 to current. Articles were excluded if the information was not clearly stated as pertaining to a residential aged care facility or if the data investigated staff knowledge or perceptions of hand hygiene. Most of the five articles included in the review reported an improvement in compliance rates. Studies were multimodal, had an education or training component, and included the promotion of alcohol-based hand rubs. Several used aspects of the World Health Organization's hand hygiene initiatives. Compliance audit tools across the studies were not consistent; thus, results may not be comparable. There are few published studies which report interventions that improve hand hygiene compliance among healthcare workers within residential aged care facilities. Successful studies included the promotion of alcoholbased hand rubs. More research is needed to improve hand hygiene compliance in the aged care sector.