A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance.

Autor: van Dijk MD; 1Department of Medical Microbiology and Infectious Diseases,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Mulder SA; 2Department of Public Health,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Erasmus V; 2Department of Public Health,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., van Beeck AHE; 2Department of Public Health,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Vermeeren JMJJ; 3Department of Quality and Patient Care,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Liu X; 2Department of Public Health,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Beeck EFV; 2Department of Public Health,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands., Vos MC; 1Department of Medical Microbiology and Infectious Diseases,Erasmus MC,University Medical Center Rotterdam,Rotterdam,The Netherlands.
Jazyk: angličtina
Zdroj: Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2019 Feb; Vol. 40 (2), pp. 187-193.
DOI: 10.1017/ice.2018.261
Abstrakt: Objective: To investigate the effects of friendly competition on hand hygiene compliance as part of a multimodal intervention program.
Design: Prospective observational study in which the primary outcome was hand hygiene compliance. Differences were analyzed using the Pearson χ2 test. Odds ratios (ORs) with 95% confidence interval were calculated using multilevel logistic regression.
Setting: Observations were performed in 9 public hospitals and 1 rehabilitation center in Rotterdam, Netherlands.ParticipantsFrom 2014 to 2016, at 5 time points (at 6-month intervals) in 120 hospital wards, 20,286 hand hygiene opportunities were observed among physicians, nurses, and other healthcare workers (HCWs).InterventionThe multimodal, friendly competition intervention consisted of mandatory interventions: monitoring and feedback of hand hygiene compliance and optional interventions (ie, e-learning, kick-off workshop, observer training, and team training). Hand hygiene opportunities, as formulated by the World Health Organization (WHO), were unobtrusively observed at 5 time points by trained observers. Compliance data were presented to the healthcare organizations as a ranking.
Results: The overall mean hand hygiene compliance at time point 1 was 42.9% (95% confidence interval [CI], 41.4-44.4), which increased to 51.4% (95% CI, 49.8-53.0) at time point 5 (P<.001). Nurses showed a significant improvement between time points 1 and 5 (P<.001), whereas the compliance of physicians and other HCWs remained unchanged. In the multilevel logistic regressions, time points, type of ward, and type of HCW showed a significant association with compliance.
Conclusion: Between the start and the end of the multimodal intervention program in a friendly competition setting, overall hand hygiene compliance increased significantly.
Databáze: MEDLINE