Has Improved Hand Hygiene Compliance Reduced the Risk of Hospital-Acquired Infections among Hospitalized Patients in Ontario? Analysis of Publicly Reported Patient Safety Data from 2008 to 2011

2013 ◽  
Vol 34 (6) ◽  
pp. 605-610 ◽  
Author(s):  
Giulio DiDiodato
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Acute Care ◽  
Poisson Regression ◽  
Hand Hygiene Compliance ◽  
Acute Care Hospitals ◽  
Ordinary Least Squares ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

Design.Prospective, observational, ecological, time series, cross-sectional study examining the association between hand hygiene compliance (HHC) rates and the incidence of hospital-acquired infections.Setting.Acute care hospitals (N = 166) located in the province of Ontario, Canada.Methods.All data were extracted from the Ontario patient safety indicator database (http://www.hqontario.ca/public-reporting/patient-safety). Complete data were available for 166 acute care hospitals from October 1, 2008, to December 31, 2011. The rates of Clostridium difficile infection (CDI) are reported monthly, methicillin-resistant Staphylococcus aureus (MRSA) bacteremia quarterly, and HHC rates yearly. Trends and associations for each indicator were evaluated by ordinary least squares regression (HHC), zero-inflated Poisson regression (MRSA bacteremia), or Poisson regression (CDI). Dependent variables included in the regression analyses were extracted from the same database and included year, healthcare region, and type of hospital (teaching or small or large community).Results.Compared to those in 2008, reported HHC rates improved every year both before and after environment/patient contact (range, 10.6%–25.3%). Compared to those in 2008, there was no corresponding change in the rates of MRSA bacteremia; however, the rates of CDI decreased in 2009 but were not statistically significantly decreased from baseline in either 2010 or 2011. No consistent association was demonstrated between changes in the rates of HHC and these two healthcare-associated infections (HAIs).Conclusions.Despite significant improvements in reported rates of HHC among healthcare personnel in Ontario's hospitals, we could not demonstrate a positive ecological impact on rates of these two HAIs.

scholarly journals Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study

2014 ◽  
Vol 100 (5) ◽  
pp. 454-459 ◽  
Author(s):  
Indah K Murni ◽  
Trevor Duke ◽  
Sharon Kinney ◽  
Andrew J Daley ◽  
Yati Soenarto
Keyword(s):  
Developing Countries ◽  
Hand Hygiene ◽  
Infection Control ◽  
Antibiotic Stewardship ◽  
Hand Hygiene Compliance ◽  
Antibiotic Use ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Rational Use Of Antibiotics ◽  
Hospital Acquired

BackgroundPrevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries.AimsTo implement a multifaceted infection control and antibiotic stewardship programme and evaluate its effectiveness on HAIs and antibiotic use.MethodsA before-and-after study was conducted over 27 months in a teaching hospital in Indonesia. All children admitted to the paediatric intensive care unit and paediatric wards were observed daily. Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of a hand hygiene campaign, antibiotic stewardship (using the WHO Pocket Book of Hospital Care for Children guidelines as standards of antibiotic prescribing for community-acquired infections), and other elementary infection control practices. Data were collected using an identical method in the preintervention and postintervention periods.ResultsWe observed a major reduction in HAIs, from 22.6% (277/1227 patients) in the preintervention period to 8.6% (123/1419 patients) in the postintervention period (relative risk (RR) (95% CI) 0.38 (0.31 to 0.46)). Inappropriate antibiotic use declined from 43% (336 of 780 patients who were prescribed antibiotics) to 20.6% (182 of 882 patients) (RR 0.46 (0.40 to 0.55)). Hand hygiene compliance increased from 18.9% (319/1690) to 62.9% (1125/1789) (RR 3.33 (2.99 to 3.70)). In-hospital mortality decreased from 10.4% (127/1227) to 8% (114/1419) (RR 0.78 (0.61 to 0.97)).ConclusionsMultifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised children in developing countries.

scholarly journals Breaking a Guinness World Record on Hand Sanitizing Relay, initiating a call for vital research in overcoming campaign fatigue for hand hygiene

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 234
Author(s):  
Wing Hong Seto ◽  
Kwok-Hung Li ◽  
Christina Woon Yee Cheung ◽  
Patricia Tai Yin Ching ◽  
Benjamin J. Cowling
Keyword(s):  
Hong Kong ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Poor Compliance ◽  
Creative Activity ◽  
World Record ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

Hand hygiene has been shown to be effective in significantly reducing hospital acquired infections for many years. However it is difficult to maintain and enhance compliance with hand hygiene guidelines. In Hong Kong, we previously reported a strategy to counter campaign fatigue from 50%-55% in 2009-11 to 83% in 2012. Here we report a creative activity that we used to sustain and enhance hand hygiene compliance. In May 2014 we broke the first Guinness World Record for a Hand Sanitizing Relay. A total of 277 participants performed hand hygiene before two official and approved witnesses. Following this team-directed strategy, an increase in hand hygiene compliance was identified in two clinical areas with previously poor compliance. The longer term impact of this strategy remains to be determined. More broadly, further research is urgently needed on meeting the challenge of campaign fatigue, and maintaining and enhancing compliance with hand hygiene guidelines.

scholarly journals The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital

2013 ◽  
Vol 6 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Mona F. Salama ◽  
Wafaa Y. Jamal ◽  
Haifa Al Mousa ◽  
Khaled A. Al-AbdulGhani ◽  
Vincent O. Rotimi
Keyword(s):  
Hand Hygiene ◽  
Teaching Hospital ◽  
Hand Hygiene Compliance ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

How practical drift and cognitive biases impact hospital hand hygiene compliance

2021 ◽  
Vol 27 (1) ◽  
pp. 12-14
Author(s):  
Charles Smith
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Cognitive Biases ◽  
Hospital Acquired Infections ◽  
Practical Drift ◽  
Hygiene Compliance ◽  
The Uk ◽  
Hospital Acquired

With hospital-acquired infections accounting for approximately 500 deaths a year in the UK, Charles Smith discusses how hand hygiene compliance can falter in hospitals and what can be done to minimise this effect.

scholarly journals Breaking a Guinness World Record on Hand Sanitizing Relay, initiating a call for vital research in overcoming campaign fatigue for hand hygiene

F1000Research ◽  
2015 ◽  
Vol 3 ◽  
pp. 234
Author(s):  
Wing Hong Seto ◽  
Kwok-Hung Li ◽  
Christina Woon Yee Cheung ◽  
Patricia Tai Yin Ching ◽  
Benjamin J. Cowling
Keyword(s):  
Hong Kong ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Poor Compliance ◽  
Creative Activity ◽  
World Record ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

Hand hygiene has been shown to be effective in significantly reducing hospital acquired infections for many years. However it is difficult to maintain and enhance compliance with hand hygiene guidelines. In Hong Kong, we previously reported a strategy to counter campaign fatigue from 50%-55% in 2009-11 to 83% in 2012. Here we report a creative activity that we used to sustain and enhance hand hygiene compliance. In May 2014 we broke the first Guinness World Record for a Hand Sanitizing Relay. A total of 277 participants performed hand hygiene before two official and approved witnesses. Following this team-directed strategy, an increase in hand hygiene compliance was identified in June 2014 in two clinical areas with previously poor compliance. The longer term impact of this strategy remains to be determined. More broadly, further research is urgently needed on meeting the challenge of campaign fatigue, and maintaining and enhancing compliance with hand hygiene guidelines.

Clinical leadership style and hand hygiene compliance

2014 ◽  
Vol 27 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Stella Christiana Stevens ◽  
Lynn Hemmings ◽  
Claire Scott ◽  
Anthony Lawler ◽  
Craig White
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Leadership Style ◽  
Hand Hygiene Compliance ◽  
Safety Performance ◽  
Clinical Leadership ◽  
Content Type ◽  
Role Modelling ◽  
Dental Staff ◽  
Hygiene Compliance

Purpose – The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance. Design/methodology/approach – A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team. Findings – A modest negative relationship between this leadership style and hand hygiene compliance rates (r=0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style. Research limitations/implications – The sample was relatively small, other attributes of leaders were not investigated. Practical implications – Leadership development for clinicians may need to focus on situational or adaptive capacity rather than a specific style. In the case of improving patient safety through increasing HH compliance, a more directive approach with clear statements backed up by role modelling appears likely to produce better rates. Originality/value – Little is known about patient safety and clinical leadership. Much of the current focus is on developing transformational, authentic or engaging style. This study provides some evidence that it should not be used exclusively.

scholarly journals Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017108 ◽  
Author(s):  
Kelly Ann Schmidtke ◽  
Navneet Aujla ◽  
Tom Marshall ◽  
Abid Hussain ◽  
Gerard P Hodgkinson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Research Ethics ◽  
Total Duration ◽  
Well Being ◽  
Hospital Acquired Infections ◽  
South Central ◽  
Priming Condition ◽  
Registration Number ◽  
Hygiene Compliance ◽  
Hospital Acquired

IntroductionCompliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients’ well-being and hospitals’ finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study.Methods and analysisThe study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards.Ethics and disseminationResearch ethics approval was obtained from the South Central—Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor.Trial registration numberISRCTN (15397624); Edge ID 86357.

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