Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study
| Autor: | Hervé Richet, Liam Donaldson, Nizam Damani, Angèle Gayet-Ageron, Orlando Urroz, Maria Luisa Moro, Ziad A. Memish, Didier Pittet, Benedetta Allegranzi, Mary-Louise McLaws, Loséni Bengaly, Julie Storr |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Infection Control/methods media_common.quotation_subject Health Personnel MEDLINE World Health Organization 03 medical and health sciences Patient safety 0302 clinical medicine Environmental protection Hygiene Intervention (counseling) Hand rubbing medicine Humans Hand Hygiene 030212 general & internal medicine media_common ddc:616 0303 health sciences Infection Control 030306 microbiology business.industry Public health World Health Organization/organization & administration Hand Disinfection/standards Odds ratio Hand Hygiene/methods Hospitals 3. Good health Gross national income Infectious Diseases Socioeconomic Factors Family medicine Health Personnel/standards Guideline Adherence/standards Guideline Adherence business Hand Disinfection |
| Zdroj: | The Lancet Infectious Diseases, Vol. 13, No 10 (2013) pp. 843-51 |
| ISSN: | 1474-4457 1473-3099 |
| Popis: | SummaryBackgroundHealth-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.MethodsWe 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.FindingsWe 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 |
| Databáze: | OpenAIRE |
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