Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study
Benedetta Allegranzi,Angèle Gayet-Ageron,Nizam Damani,Loséni Bengaly,Mary-Louise McLaws,Maria Luisa Moro,Ziad A. Memish,Orlando Urroz,Hervé Richet,Julie Storr,Liam Donaldson,Didier Pittet +11 more
TLDR
Implementation of WHO's hand-hygiene strategy is feasible and sustainable across a range of settings in different countries and leads to significant compliance and knowledge improvement in health-care workers, supporting recommendation for use worldwide.Abstract:
Summary Background Health-care-associated infections are a major threat to patient safety worldwide. Transmission is mainly via the hands of health-care workers, but compliance with recommendations is usually low and effective improvement strategies are needed. We assessed the effect of WHO's strategy for improvement of hand hygiene in five countries. Methods We did a quasi-experimental study between December, 2006, and December, 2008, at six pilot sites (55 departments in 43 hospitals) in Costa Rica, Italy, Mali, Pakistan, and Saudi Arabia. A step-wise approach in four 3–6 month phases was used to implement WHO's strategy and we assessed the hand-hygiene compliance of health-care workers and their knowledge, by questionnaire, of microbial transmission and hand-hygiene principles. We expressed compliance as the proportion of predefined opportunities met by hand-hygiene actions (ie, handwashing or hand rubbing). We assessed long-term sustainability of core strategy activities in April, 2010. Findings We noted 21 884 hand-hygiene opportunities during 1423 sessions before the intervention and 23 746 opportunities during 1784 sessions after. Overall compliance increased from 51·0% before the intervention (95% CI 45·1–56·9) to 67·2% after (61·8–72·2). Compliance was independently associated with gross national income per head, with a greater effect of the intervention in low-income and middle-income countries (odds ratio [OR] 4·67, 95% CI 3·16–6·89; p Interpretation Implementation of WHO's hand-hygiene strategy is feasible and sustainable across a range of settings in different countries and leads to significant compliance and knowledge improvement in health-care workers, supporting recommendation for use worldwide. Funding WHO, University of Geneva Hospitals, the Swiss National Science Foundation, Swiss Society of Public Health Administration and Hospital Pharmacists.read more
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Predictors of heavy stethoscope contamination following a physical examination
TL;DR: Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient’s skin, and prevention of pathogen dissemination is needed.
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Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control.
Ermira Tartari,Ermira Tartari,Carolina Fankhauser,Sarah Masson-Roy,Hilda Márquez-Villarreal,Inmaculada Fernández Moreno,Ma Luisa Rodriguez Navas,Odet Sarabia,Fernando Bellissimo-Rodrigues,Marcela Hernández-de Mezerville,Yew Fong Lee,Yew Fong Lee,Mohammad Hassan Aelami,Shaheen Mehtar,Americo Agostinho,Liberato Camilleri,Benedetta Allegranzi,Daniela Pires,Daniela Pires,Didier Pittet +19 more
TL;DR: The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking and IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.
Journal ArticleDOI
Monitoring the hand hygiene compliance of health care workers in a general intensive care unit: Use of continuous closed circle television versus overt observation.
Evgeni Brotfain,Ilana Livshiz-Riven,Alexander Gushansky,Alexander Erblat,Leonid Koyfman,Tomer Ziv,Lisa Saidel-Odes,Moti Klein,Abraham Borer +8 more
TL;DR: It is demonstrated that CCTV is an appropriate, reliable, and neutral method for observation of hand hygiene, and there is no clear basis for incorporating a CCTV observation modality into a health care system that already operates an overt observation program.
Journal ArticleDOI
Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital.
V Baccolini,V D'Egidio,Pasquale de Soccio,Giuseppe Migliara,Azzurra Massimi,Francesco Alessandri,Guglielmo Tellan,Carolina Marzuillo,Corrado De Vito,Marco Ranieri,Paolo Villari +10 more
TL;DR: The multimodal intervention resulted in a significant improvement in compliance with standard hygiene precautions, however, regular educational reinforcement and feedback is essential to maintain a high and uniform level of compliance.
Journal ArticleDOI
Implementation of hand hygiene in health-care facilities: results from the WHO Hand Hygiene Self-Assessment Framework global survey 2019
Marlieke E. A. de Kraker,Ermira Tartari,Sara Tomczyk,Anthony Twyman,Laurent C. Francioli,Alessandro Cassini,Benedetta Allegranzi,Didier Pittet +7 more
TL;DR: Most health-care facilities had an intermediate level of hand hygiene implementation or higher, for which health-Care facility funding and country income level were important drivers.
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