scholarly journals Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe

2013 ◽  
Vol 34 (4) ◽  
pp. 415-423 ◽  
Author(s):  
Victor D. Rosenthal ◽  
Mandakini Pawar ◽  
Hakan Leblebicioglu ◽  
Josephine Anne Navoa-Ng ◽  
Wilmer Villamil-Gómez ◽  
...  

Objective.To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multi-dimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.Design.An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.Setting.Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.Participants.Healthcare workers at 99 ICU members of the INICC.Methods.A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.Results.A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P<.001), physicians versus nurses (62% vs 72%; P<.001), and adult versus neonatal ICUs (67% vs 81%; P<.001), among others.Conclusions.Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented.

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Cassie Cunningham Goedken ◽  
Daniel J. Livorsi ◽  
Michael Sauder ◽  
Mark W. Vander Weg ◽  
Emily E. Chasco ◽  
...  

Abstract Background Implementation science experts define champions as “supporting, marketing, and driving through an implementation, overcoming indifference or resistance that the intervention may provoke in an organization.” Many hospitals use designated clinical champions—often called “hand hygiene (HH) champions”—typically to improve hand hygiene compliance. We conducted an ethnographic examination of how infection control teams in the Veterans Health Administration (VHA) use the term “HH champion” and how they define the role. Methods An ethnographic study was conducted with infection control teams and frontline staff directly involved with hand hygiene across 10 geographically dispersed VHA facilities in the USA. Individual and group semi-structured interviews were conducted with hospital epidemiologists, infection preventionists, multi-drug-resistant organism (MDRO) program coordinators, and quality improvement specialists and frontline staff from June 2014 to September 2017. The team coded the transcripts using thematic content analysis content based on a codebook composed of inductive and deductive themes. Results A total of 173 healthcare workers participated in interviews from the 10 VHA facilities. All hand hygiene programs at each facility used the term HH champion to define a core element of their hand hygiene programs. While most described the role of HH champions as providing peer-to-peer coaching, delivering formal and informal education, and promoting hand hygiene, a majority also included hand hygiene surveillance. This conflation of implementation strategies led to contradictory responsibilities for HH champions. Participants described additional barriers to the role of HH champions, including competing priorities, staffing hierarchies, and turnover in the role. Conclusions Healthcare systems should consider narrowly defining the role of the HH champion as a dedicated individual whose mission is to overcome resistance and improve hand hygiene compliance—and differentiate it from the role of a “compliance auditor.” Returning to the traditional application of the implementation strategy may lead to overall improvements in hand hygiene and reduction of the transmission of healthcare-acquired infections.


2018 ◽  
Vol 5 (2) ◽  
pp. 81-88
Author(s):  
Muhammad Saefulloh ◽  
Heri Sugiarto ◽  
Suwanto Suwanto

ABSTRAK Menjaga kebersihan tangan merupakan upaya pencegahan infeksi nosokomial yang ditularkan melalui tangan. Penelitian ini bertujuan untuk mengetahui hubungan antara motivasi dengan kepatuhan perawat dalam praktik kebersihan tangan di ruang Bedah RSUD Indramayu Tahun 2017. Metode Penelitian ini merupakan penelitian survei analitik dengan pendekatan cross sectional. Sampel penelitian ini sebanyak 30 perawat yang bekerja di ruang Bedah RSUD Kabupaten Indramayu. Alat pengumpulan data menggunakan kuesioner. Berdasarkan hasil penelitian diketahui motivasi tinggi sebanyak 66,7%. Dan kepatuhan perawat dengan kategori patuh sebesar 90,0%. Hasil analisis bivariat menunjukan p-value sebesar 0,03 dan α = 0,05 yang berarti ada hubungan antara motivasi dengan kepatuhan perawat dalam praktik kebersihan tangan di ruang Bedah RSUD Kabupaten Indramayu tahun 2017 (p-value 0,03, α = 0,05). Saran dari penelitian ini adalah perawat dipaparkan untuk menjaga kebersihan tangan dan meningkatkan ketaatan kebersihan tangan untuk mengurangi infeksi nosokomial Kata Kunci : Kebersihan tangan, motivasi, kepatuhan ABSTRACT Keeping hand hygiene will prevent the nosocomial infection that is transmitted by hand. The objective of this study is to find the correlation between motivation towards nurses obedience in implementing hand hygiene at Surgery care room RSUD Kabupaten Indramayu year 2017. The study used correlation methode with Crossectional approach. The sample were 30 nurses in Surgery care room RSUD Kabupaten Indramayu. The instrument used questioner. The data was analized by Chi square. The correlation showed that high motivation is 66,7%. Nurse compliance in hand hygiene practice as much as 90,0%. Bivariate analize showed that there is a correlation between motivation towards nurse obedience in implementing hand hygiene at Surgery care room RSUD Kabupaten Indramayu should be 2017 (p-value 0.03, α = 0.05) Suggestion from this study are nurses exposed to maintain hand hygiene and improve hand hygiene compliance to reduce nosocomial infections. Keywords : Hand Hygiene, Motivation, Obedience.


Author(s):  
Anne-Mette Iversen ◽  
Marie Stangerup ◽  
Michelle From-Hansen ◽  
Rosa Hansen ◽  
Louise Palasin Sode ◽  
...  

2021 ◽  
pp. 1-23
Author(s):  
Henrico van Roekel ◽  
Joanne Reinhard ◽  
Stephan Grimmelikhuijsen

Abstract Nudging has become a well-known policy practice. Recently, ‘boosting’ has been suggested as an alternative to nudging. In contrast to nudges, boosts aim to empower individuals to exert their own agency to make decisions. This article is one of the first to compare a nudging and a boosting intervention, and it does so in a critical field setting: hand hygiene compliance of hospital nurses. During a 4-week quasi-experiment, we tested the effect of a reframing nudge and a risk literacy boost on hand hygiene compliance in three hospital wards. The results show that nudging and boosting were both effective interventions to improve hand hygiene compliance. A tentative finding is that, while the nudge had a stronger immediate effect, the boost effect remained stable for a week, even after the removal of the intervention. We conclude that, besides nudging, researchers and policymakers may consider boosting when they seek to implement or test behavioral interventions in domains such as healthcare.


2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan


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