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
Citations
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Hand washing practices and techniques among health professionals in a tertiary hospital in Kano
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The effect of incorporating covert observation into established overt observation-based hand hygiene promotion programs
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Hand Hygiene Among Hospital Staff: A Survey of Knowledge, Attitude, and Practice in A General Hospital in Syria
Cornelis Jonker,Maha Othman +1 more
TL;DR: The questionnaire showed that there was a significant correlation between knowledge, attitude, and facilities on the one hand and poor self-reported adherence on the other, and poor adherence was high in ICU, among younger and unaware participants.
References
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Effectiveness of a hospital-wide programme to improve compliance with hand hygiene
Didier Pittet,Stéphane Hugonnet,Stéphan Juergen Harbarth,Philippe Mourouga,V Sauvan,Sylvie Touveneau,Thomas V. Perneger +6 more
TL;DR: The campaign produced a sustained improvement in compliance with hand hygiene, coinciding with a reduction of nosocomial infections and MRSA transmission, and the promotion of bedside, antiseptic handrubs largely contributed to the increase in compliance.
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Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis
Benedetta Allegranzi,Sepideh Bagheri Nejad,Christophe Combescure,Wilco Graafmans,Homa Attar,Liam Donaldson,Didier Pittet,Didier Pittet +7 more
TL;DR: The epidemiology of endemic health-care-associated infection in developing countries is assessed and a need to improve surveillance and infection-control practices is indicated.
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Financial crisis, austerity, and health in Europe
Marina Karanikolos,Marina Karanikolos,Philipa Mladovsky,Jonathan Cylus,Sarah Thomson,Sanjay Basu,David Stuckler,Johan P. Mackenbach,Martin McKee,Martin McKee +9 more
TL;DR: Although there are many potentially confounding differences between countries, the analysis suggests that the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe.
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Infection Control — A Problem for Patient Safety
TL;DR: Nosocomial infections are today by far the most common complications affecting hospitalized patients, and a single type of nosocomial infection — surgical-wound infection — constituted the second-largest category of adverse events.
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Systematic Review of Studies on Compliance with Hand Hygiene Guidelines in Hospital Care
Vicki Erasmus,Thea J. Daha,Hans Brug,Jan Hendrik Richardus,Myra D. Behrendt,Margreet C. Vos,Ed F. van Beeck +6 more
TL;DR: Noncompliance with hand hygiene guidelines is a universal problem, which calls for standardized measures for research and monitoring andoretical models from the behavioral sciences should be used internationally and should be adapted to better explain the complexities of hand hygiene.