Hand Hygiene Promotion Research Articles

Use of hand hygiene agents as a surrogate marker of compliance in Hungarian long-term care facilities: first nationwide survey

BackgroundHand hygiene practice is an important measure for preventing infections in long-term care facilities (LTCFs). However, low compliance with hand hygiene has been reported in a number of studies. The purpose of this study was to provide an overview of the first reference data collected on alcohol-based handrub (ABHR) and antiseptic soap consumption, as surrogate markers for hand hygiene compliance by healthcare workers (HCWs) in Hungarian LTCFs. The objective was to inform stakeholders on the need of hand hygiene improvement in these settings.MethodsBetween 5 May and 30 September 2014, we conducted a nationwide, cross-sectional survey using a standardized self-administered questionnaire; all Hungarian LTCFs were eligible. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis.ResultsThe questionnaire was completed by 354 LTCFs, representing 24 % of all Hungarian LTCFs. In total, the median consumption of ABHR and antimicrobial soap was 15.5 L (IQR, 0–800 L) and 60 L (IQR, 0–1,680 L) per LTCFs, and 2.2 mL (IQR, 0.4–9.1 mL) and 12.1 mL (IQR, 0.7–32.8 mL) per HCWs in 2013, respectively. The estimated number of hand hygiene actions was 0.6 hygienic handrub/HCW per day (IQR, 0–12.8/HCWs) and 2.4 hygienic handwashing/HCW per day (IQR, 0–21.9/HCWs; P = .001), respectively.ConclusionsThis study suggests that non-compliance with hand hygiene is a significant problem in Hungarian LTCFs. Based on our results, there is an urgent need for a nationwide multimodal hand hygiene promotion strategy including education and performance monitoring and feedback in all LTCFs. Furthermore, monitoring of ABHR consumption constitute an additional component of the existing National Nosocomial Surveillance system.

Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis

Objective To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize...

Bridging the 10/90 gap: Can Bangladesh provide a developing world model for influenza and pneumonia research?

Despite the fact that developing countries carry more than 90 global disease burden, only a small fraction of global medical research addresses their problems. It is interesting to note that even in the field of acute respiratory tract infections, a leading cause of mortality in poor settings, there has been disproportionately little research performed in developing countries. Using Bangladesh as an example, we discuss how clinical trials to address the most important health problems of the developing world (that are also of relevance to the developed world) have been and can continue to be conducted in resource poor countries. To start with, we propose to conduct, in partnership with colleagues from resource rich countries, an influenza vaccine trial in Bangladesh to assess the efficacy of trivalent influenza vaccine, with and without the addition of supplementary measures like the promotion of hand hygiene in reducing pneumonia mortality among children under 5 years of age. Such research may produce a win-win situation for both developed and developing countries.

The role of parents on hand hygiene promotion in the pediatric setting – a systematic review

The parental instinct of offspring protection has evolved and perpetuated for millenniums across a wide range of species. When a child is sick and particularly when it is hospitalized, parents and other caregivers have to share their natural and social role of child protection with the healthcare workers. This may create conflict but also the opportunity for establishing a partnership between all actors in favor of delivering safe care to the child. One of the main issues on that partnership is the promotion of hand hygiene (HH) because both parents and healthcare workers must respect HH, which is considered the most effective preventive measure against health-care associated infections (HAI).

Promoting hygienic hand disinfection as an ongoing task: results of a cluster-randomized controlled trial to (re-)raise compliance of physicians and nurses based on psychological tailoring in a tertiary intensive care setting

Insufficient use of psychological theory is one reason that conclusive evidence regarding hand hygiene promotion is scarce. In addition, compliance has been shown to be lower among physicians than among nurses. The PSYGIENE-project set out to draw on theoretical advances (Health Action Process Approach-HAPA) to optimise education and feedback interventions.

Promoting hand hygiene in intensive care: “PCI Licence”

Improving hand hygiene (HH) compliance among healthcare workers (HCWs) in ICUs requires innovative, specific and customized strategies.

Should alcohol-based handrub volume be customized according to the size of healthcare workers’ hands?

Hand hygiene promotion is the most important tool to prevent health-care associated infections. While hand hygiene compliance has been well studied and promoted for the last 20 years, less attention has been devoted to study the quality of hand hygiene action.

Train the trainers: replicating the message of hand hygiene promotion through the training of national experts, preliminary results

Despite being the most effective preventive measure against health-care associated infections (HAI), hand hygiene (HH) practices are still suboptimal all around the world, with compliance among healthcare workers generally falling below 50% of the opportunities to perform it. One of the potential strategies for HH promotion at national level is to “Train the Trainers”, i.e., to train well-recognized national experts on the implementation of the World Health Organization (WHO) Multimodal Strategy for HH Improvement.

Cost-effectiveness of hand hygiene promotion for MRSA blood stream infection in ICU settings

Multimodal interventions are effective in increasing hand hygiene compliance amongst healthcare workers, but it is not known whether such interventions are cost-effective outside high-income countries.

Effectiveness after 5 years of the who hand hygiene promotion strategy to reduce health-care-associated infections at Hung Vuong Hospital, Vietnam

Hung Vuong hospital (HVH) is a 900 bed maternity hospital in Ho Chi Minh City, Vietnam, with at least 40’000 deliveries per year. In 2009, at Hung Vuong hospital (HVH), hand hygiene compliance among healthcare staff was low (8%) while the rates of neonatal hospital-acquired infections (HAIs) were quite high (15.7%). There was the need for promoting hand hygiene using the WHO strategy to improve staff compliance and possibly reduce HAIs.

Promoting hand hygiene program via social media

Methods and materials One 3 minutes-long video of HH campaign in 8 language was posted on the YouTube. The Chinese version had been promoted through three platforms, including the official hospital website, hospital group e-mail, and the Facebook site of one famous internet celebrity, who was also 6th grade medical student of the school the hospital affiliated to. The video traffic of the Chinese version during May 5, to Dec, 31, 2014 was analyzed via Google Analytics. The HH compliance was observed and compared in Nov. of 2013 and Nov. 2014, separately.

Impact of six multimodal country-wide campaigns to promote hand hygiene in Belgian hospitals

Six campaigns sponsored by the Belgian federal government were organized to promote hand hygiene(HH) in Belgian hospitals between 2005 and 2015. The campaigns combined educational sessions for healthcare workers (HCWs), promotion of alcohol-based hand rubs, patient awareness and audits with performance feedback. Each campaign consisted of a pre-campaign data collection period, an awareness period with training and a post-campaign data collection period.

Hand hygiene promotion and culture innovation

Hand hygiene promotion and culture innovation

Hand hygiene promotion and the participation of infection control link nurses: An effective innovation to overcome campaign fatigue

Hand hygiene promotion and the participation of infection control link nurses: An effective innovation to overcome campaign fatigue

Saving time and resources: Observational research to support adoption of a hand hygiene promotion campaign

Hand hygiene is the most effective way to prevent the spread of health care-associated infections, but many facilities may not have the resources or expertise to develop their own hand hygiene promotion campaign. This observational study demonstrated that a campaign developed for 1 facility could successfully contribute to behavior change at another, unrelated facility. It serves as a model and evidence that health care facilities can successfully adopt hand hygiene promotion campaigns developed and validated at other facilities.

Interventional Strategies to Contain Colonization and Infections Caused By Carbapenemase Producing Klebsiella Pneumonia in Haematological Malignancies

Background and Aim: The emergence and dissemination of Carbapenemase producing Klebsiella pneumoniae (KPC) represent a serious threat to public health and is associated with high mortality rates in patients with hematologic malignancies. Several risk factors (prior exposure to or current use of antibiotics, extended stay in hospital, neutropenia, sharing a room with a know carrier etc) have been identified for colonization in hematological patients. However, data on how to contain their spread in haematological setting are still surprisingly limited. We carried out a prospective investigation to assess the prevalence of KPC colonization among hematologic patients, the impact of a strategy control to limit the spread and to evaluate the efficacy of an implementation of more extensive active surveillance.Methods: Infections caused by multiresistant pathogens have been recorded in our Unit from January 2012 through June 2014. From January 2012 to July 2013, we developed an intensive control infection program, (Plan A): 1. Weekly colonization screening for KPC; 2. Educate healthcare personnel about KPC; 3. Promotion of hand hygiene 4. Physical separation of carriers from non-carriers 5. A double-carbapenem plus colistin therapeutic empiric regimen was given for blood stream infections. Since July 2013, we decided to implement additional measures, including (Plan B): 1. Drastic reduction in the number of beds. 2. 2% chlorhexidine body washing for colonized patients. 3. Ensure access to adequate hand hygiene stations (i.e., clean sinks and/or alcohol) and ensure they are well stocked with supplies (e.g. towels, soap, etc.) 4. Donning gown and gloves before entering the affected patient’s room and removing the gown and gloves and performing hand hygiene prior to exiting the affected patient’s room.Results: Since January 2012 perianal swabs were detected weekly from 607 consecutive patients affected by hematologic malignancies, for a total of 1079 admissions and 12.284 days of hospital stay.KPC colonization was present in 47 out of 607 (7.7%) screened patients at some time during their (often multiple hospitalizations); 11 bloodstream infections were reported in 9 patients (23%). Three deaths (3/11, 27%) due to KPC were reported before implementation screening (overall mortality rate was 6.3 % of colonized patients). KPC-decolonisation was achieved in 13/47 pts (28 %) after a median duration of 88 days (range 20-118).Most patients who recovered from KPC infection or were just colonized by KPC went on to receive additional chemotherapy without any life threatening KPC infection occurring (only one patient reported two septic episodes). Since screening cultures or further clinical cultures identified a progressive increase KPCcolonized or -infected patients, we decided to implement additional measures (Plan B). Therefore, from fourth trimester 2013 of study, we have observed a progressive decrease in rate of new colonization: 2 patients (4.17%) vs 15 patients (30%) in the third trimester, and a very low rate was maintained until the second trimester of 2014( 3 patients -4%).Conclusions: The prevalence of KPC colonization in our hospital is high among patients with hematologic diseases.An implementation of additional measures, sharing the patients in single bed-rooms and consequently limiting transfer of cases from other wards, was able to contain KPC colonization and infection.However, the success of our preliminary interventions should be monitored constantly; besides, to prevent the emergence and further spread of CRE, a coordinated regional control effort among healthcare facilities should be recommended. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

1518Hand Hygiene for Patients: an Initiative to Study and Promote Hand Hygiene Practice for Hospitalized Patients

1518Hand Hygiene for Patients: an Initiative to Study and Promote Hand Hygiene Practice for Hospitalized Patients

Effectiveness of Hand Hygiene Promotion in Relation to Level of Investment: A Systematic Review.

Effectiveness of Hand Hygiene Promotion in Relation to Level of Investment: A Systematic Review.

Public health campaign to promote hand hygiene before meals in a college of veterinary medicine.

Veterinary students can be exposed to environmental infectious agents in school that may include zoonotic pathogens. Encouraging effective hand hygiene can minimize the spread of zoonoses and promote public health and the One Health concept among veterinary students. The purpose of this study was to determine if a campaign could improve hand hygiene among veterinary students at extracurricular meetings serving meals. Nine Kansas State University College of Veterinary Medicine (KSU-CVM) extracurricular organizations participated in the study, sanitizer was provided at each meeting, and baseline hand-hygiene data were observed. A hand-hygiene opportunity was defined as any student observed to approach the buffet food line. Sanitizer use (yes/no) and gender (male/female) were recorded. Campaign interventions included a 3.5-minute educational video and a novel motivational poster. The video was presented to all first-year, second-year, and third-year veterinary students. Posters encouraging hand sanitization were displayed on doors and tables alongside sanitizers at each meeting. Observational hand-hygiene data were collected immediately after introduction of interventions and again 3 months later. Environmental sampling for presence of bacteria in and around meeting locations was also performed. Observed hand hygiene was lowest during baseline (11.0% ± 1.7), improved significantly post-intervention (48.8% ± 3.2), and remained improved at 3-month follow-up (33.5% ± 4.0). Females had higher probability of hand sanitizing (35.9% ± 2.2) than males (21.4% ± 2.4) (p<.01). Clostridium perfringens was isolated from 2/42 samples, and Salmonella spp. were isolated from 4/42 samples. A short-term public health campaign targeting veterinary students successfully improved hand hygiene before meals.

Implementation and Impact of an Automated Group Monitoring and Feedback System to Promote Hand Hygiene Among Health Care Personnel

Despite substantial evidence to support the effectiveness of hand hygiene for preventing health care-associated infections, hand hygiene practice is often inadequate. Hand hygiene product dispensers that can electronically capture hand hygiene events have the potential to improve hand hygiene performance. A study on an automated group monitoring and feedback system was implemented from January 2012 through March 2013 at a 140-bed community hospital. An electronic system that monitors the use of sanitizer and soap but does not identify individual health care personnel was used to calculate hand hygiene events per patient-hour for each of eight inpatient units and hand hygiene events per patient-visit for the six outpatient units. Hand hygiene was monitored but feedback was not provided during a six-month baseline period and three-month rollout period. During the rollout, focus groups were conducted to determine preferences for feedback frequency and format. During the six-month intervention period, graphical reports were e-mailed monthly to all managers and administrators, and focus groups were repeated. After the feedback began, hand hygiene increased on average by 0.17 events/patient-hour in inpatient units (interquartile range = 0.14, p = .008). In outpatient units, hand hygiene performance did not change significantly. A variety of challenges were encountered, including obtaining accurate census and staffing data, engendering confidence in the system, disseminating information in the reports, and using the data to drive improvement. Feedback via an automated system was associated with improved hand hygiene performance in the short-term.