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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References
More filters
Journal ArticleDOI
Knowledge of standard and isolation precautions in a large teaching hospital.
Hugo Sax,Thomas V. Perneger,Stéphane Hugonnet,Pascale Herrault,Marie-Noëlle Chraïti,Didier Pittet +5 more
TL;DR: Despite a training effort targeting opinion leaders, knowledge of transmission precautions for pathogens remained insufficient and specific training proved to be the major determinant of “good knowledge”.
Journal ArticleDOI
Assessing patient safety culture in hospitals across countries.
TL;DR: Comparisons and differences in hospital patient safety culture in three countries have shown similarities and differences within and between countries.
Journal ArticleDOI
Cost implications of successful hand hygiene promotion.
TL;DR: The total cost of the hand hygiene promotion corresponded to less than 1% of the costs associated with nosocomial infections and it is probably cost-saving, according to the evaluated campaign that emphasized alcohol-based handrubs.
Journal ArticleDOI
Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology
Vincent C.C. Cheng,Josepha W.M. Tai,Sara K.Y. Ho,Jasper Fuk-Woo Chan,Kwan Ngai Hung,Pak-Leung Ho,Kwok-Yung Yuen +6 more
TL;DR: MedSense provides an unobtrusive and objective measurement of hand hygiene compliance and is important for staff training by the infection control team and allocation of manpower by hospital administration.
Journal ArticleDOI
Bundling hand hygiene interventions and measurement to decrease health care–associated infections
TL;DR: Eight key components of this bundle are proposed as a cohesive program to enable the deployment of synergistic, coordinated efforts to promote good hand hygiene practice and can lead to sustained infection reduction.