Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study

Autor: Tjallie, van der Kooi, Hugo, Sax, Hajo, Grundmann, Didier, Pittet, Sabine, de Greeff, Jaap, van Dissel, Lauren, Clack, Albert W, Wu, Judith, Davitt, Sofia, Kostourou, Alison, Maguinness, Anna, Michalik, Viorica, Nedelcu, Márta, Patyi, Janja, Perme Hajdinjak, Milena, Prosen, David, Tellez, Éva, Varga, Fani, Veini, Mirosław, Ziętkiewicz, Walter, Zingg
Přispěvatelé: Institut Català de la Salut, [van der Kooi T, de Greeff S, van Dissel J] RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands. [Sax H] Clinic for Infectious Diseases and Hospital Hygiene, University Hospital Zürich, Zurich, Switzerland. [Grundmann H] Medical Center – University of Freiburg, Freiburg, Germany. [Pittet D] University of Geneva Hospitals, Geneva, Switzerland. WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland. [Tellez D] Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, University of Zurich, Zingg, Walter
Rok vydání: 2022
Předmět:
Microbiology (medical)
Otros calificadores::Otros calificadores::/prevención & control [Otros calificadores]
Health Personnel
11549 Institute of Implementation Science in Health Care
Individual
Intervention
610 Medicine & health
Higiene
2726 Microbiology (medical)
10234 Clinic for Infectious Diseases
Personal sanitari
Other subheadings::Other subheadings::/prevention & control [Other subheadings]
Multicentre
2736 Pharmacology (medical)
Therapeutics::Hygiene::Hand Hygiene [ANALYTICAL
DIAGNOSTIC AND THERAPEUTIC TECHNIQUES
AND EQUIPMENT]
Humans
Pharmacology (medical)
Hand Hygiene
Activity index
personas::grupos profesionales::personal sanitario [DENOMINACIONES DE GRUPOS]
terapéutica::higiene::higiene de manos [TÉCNICAS Y EQUIPOS ANALÍTICOS
DIAGNÓSTICOS Y TERAPÉUTICOS]
Infeccions nosocomials - Prevenció
Cross Infection
infecciones bacterianas y micosis::infección::infección hospitalaria [ENFERMEDADES]
Public Health
Environmental and Occupational Health
Persons::Occupational Groups::Health Personnel [NAMED GROUPS]
2739 Public Health
Environmental and Occupational Health
2725 Infectious Diseases
Bacterial Infections and Mycoses::Infection::Cross Infection [DISEASES]
Intensive Care Units
Infectious Diseases
Intensive care
Guideline Adherence
Zdroj: Scientia
van der Kooi, Tjallie; Sax, Hugo; Grundmann, Hajo; Pittet, Didier; de Greeff, Sabine; van Dissel, Jaap; Clack, Lauren; Wu, Albert W; Davitt, Judith; Kostourou, Sofia; Maguinness, Alison; Michalik, Anna; Nedelcu, Viorica; Patyi, Márta; Perme Hajdinjak, Janja; Prosen, Milena; Tellez, David; Varga, Éva; Veini, Fani; Ziętkiewicz, Mirosław; ... (2022). Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study. Antimicrobial resistance and infection control, 11(1), p. 123. BioMed Central 10.1186/s13756-022-01148-1
ISSN: 2047-2994
Popis: Background Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the “Prevention of Hospital Infections by Intervention and Training” (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect. Methods We included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman’s rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns. Results In total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18–0.97], and their median HH increase (ρ = 0.79 [0.08–0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance. Conclusions Both the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs’ overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future.
Databáze: OpenAIRE
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