Improving Hand Hygiene Adherence in Healthcare Workers Before Patient Contact: A Multimodal Intervention in Four Tertiary Care Hospitals in Japan

2020 ◽  
Vol 15 (2020-05) ◽  
pp. 262-267 ◽  
Author(s):  
Akihiko Saitoh ◽  
Kiyomi Sato ◽  
Yoko Magara ◽  
Kakuei Osaki ◽  
Kiyoko Narita ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Tertiary Care ◽  
Hospital Setting ◽  
World Health ◽  
Multimodal Intervention ◽  
Percentage Points ◽  
Hygiene Intervention ◽  
Before And After ◽  
Tertiary Hospitals ◽  
Health Organization

OBJECTIVES: Our objectives were to evaluate hand hygiene adherence among physicians and nurses before touching hospitalized patients and to evaluate changes in hand hygiene adherence after a multimodal intervention was implemented. DESIGN, SETTING, AND PARTICIPANTS: We conducted a pre- and postintervention study with HCWs at four tertiary hospitals in Niigata, Japan. Hand hygiene observations were conducted from June to August 2018 (preintervention) and February to March 2019 (postintervention). INTERVENTION: The multimodal hand hygiene intervention recommended by the World Health Organization was tailored to each hospital and implemented from September 2018 to February 2019. MAIN OUTCOMES AND MEASURES: We observed hand hygiene adherence before touching patients in each hospital and compared rates before and after intervention. Intervention components were also evaluated. RESULTS: There were 2,018 patient observations preintervention and 1,630 postintervention. Overall, hand hygiene adherence improved from 453 of 2,018 preintervention observations (22.4%) to 548 of 1,630 postintervention observations (33.6%; P < .001). Rates improved more among nurses (13.9 percentage points) than among doctors (5.7 percentage points). Improvement varied among the hospitals: Hospital B (18.4 percentage points) was highest, followed by Hospitals D (11.4 percentage points), C (11.3 percentage points), and Hospital A (6.5 percentage points). CONCLUSIONS: A multimodal intervention improved hand hygiene adherence rates in physicians and nurses in Niigata, Japan; however, further improvement is necessary. Given the current suboptimal hand hygiene adherence rates in Japanese hospitals, the spread of COVID-19 within the hospital setting is a concern.

scholarly journals 1193. Assessing Sustainability of Hand Hygiene Adherence 5 Years after a Contest-Based Intervention in 3 Japanese Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S428-S428
Author(s):  
Tomoko Sakihama ◽  
Naomi Kayauchi ◽  
Sanjay Saint ◽  
Karen E Fowler ◽  
David Ratz ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Direct Observation ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
World Health ◽  
Intervention Period ◽  
Post Intervention ◽  
Multimodal Intervention ◽  
Health Organization ◽  
Survey Responses

Abstract Background To evaluate the 5-year sustainability of a multimodal intervention which included a prize to the hospital with the highest overall hand hygiene adherence rates among healthcare workers. Methods Design: An observational study using direct observation of hand hygiene adherence performed by a trained observer coupled with a survey of healthcare workers about their knowledge of hand hygiene practices. Setting: Three Japanese tertiary care hospitals. Study Population: Physicians and nurses working on an inpatient medical or surgical ward, an intensive care unit (ICU), or the emergency department. Outcome Measures: Hand hygiene adherence rates before patient contact using unobtrusive direct observation. Secondary outcomes were survey responses on a World Health Organization (WHO) questionnaire on hand hygiene. Results Data for the current study were collected between September and December 2017 at the 3 participating hospitals. An additional 2,485 observations were conducted during this 5-year post-intervention assessment. These observations were compared with 2,679 observations from the pre-intervention period, and 2,982 observations from the 6-month post-intervention period. Hand hygiene adherence rates had previously improved significantly after the introduction of a multimodal intervention – based on principles recommend by the WHO – in 2012 and 2013 in 3 Japanese hospitals (18.0% pre-intervention to 32.7% 6-months post-intervention; P < 0.001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5-years post-intervention; P = 0.53); however, substantial variability in hand hygiene adherence by unit and healthcare worker type was noted. Conclusion A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention. Disclosures All authors: No reported disclosures.

scholarly journals Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

2017 ◽  
Vol 22 (23) ◽  
Author(s):  
Maria Luisa Moro ◽  
Filomena Morsillo ◽  
Simona Nascetti ◽  
Mita Parenti ◽  
Benedetta Allegranzi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Absolute Increase ◽  
Italian Regions ◽  
Hygiene Promotion ◽  
Before And After ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Implementation Progress

A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.

scholarly journals Educational sessions may not be enough to improve knowledge about hand hygiene: Assessing the knowledge about hand hygiene of health workers before and after an educational workshop in Sudan

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 449 ◽  
Author(s):  
Ihab B. Abdalrahman ◽  
Sara Shamat ◽  
Sara Mamoun ◽  
Reem Abdelraheem ◽  
Esraa Salah ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Workers ◽  
Public Hospitals ◽  
World Health ◽  
Improvement Project ◽  
Before And After ◽  
Health Organization ◽  
Almost All ◽  
Educational Workshop

Background: In an attempt to defeat the high prevalence of health care associated infections, by raising the awareness about hand hygiene, we implemented a quasi-experimental study as part of a quality improvement project to evaluate the efficacy of focused educational workshop on knowledge about hand hygiene among health care workers in Sudan. Methods: Seventy-three participants were recruited from two public hospitals and one private hospital in Khartoum, Sudan in September 2017. The knowledge before and after the educational workshop was assessed for each participant using the World Health Organization hygiene associated infection questionnaire. We analyzed data using SPSS v22 and used McNemar’s test to compare knowledge before and after the workshop. Results: Around 40% of participants worked in general ward and 85% of them were women. Almost 70% were midwives or nurses. The mean age of participants was 28.4 years. We compared the knowledge of hand hygiene between nurses and doctors before the workshop, and the results showed that nurses had better knowledge in almost all aspects of hand hygiene. When we compared the knowledge before and immediately after the workshop for all participants, we found that there was no significant improvement in almost all aspects of knowledge about hand hygiene (P>0.05). Conclusion: Comparing the knowledge before and after the workshop, we found no significant improvement in almost all aspects of hand hygiene. Of note, nurses’ knowledge about hand hygiene was consistently higher than doctors.  Additional studies are needed to identify the optimal design of educational sessions.

scholarly journals Evaluation of drug promotional literatures in a tertiary care hospital setting in South India

2021 ◽  
Vol 10 (5) ◽  
pp. 527
Author(s):  
Ravi H. Kudthni ◽  
Fazeel Zubair Ahmed ◽  
Sangala Srimanth Madanna ◽  
Samba Siva Raju Derangula ◽  
Pothuru Anil Kumar
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Endocrine System ◽  
Medical Practitioner ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Health Organization ◽  
Many Sources

Background: The drug promotional literature is one of many sources for seeking information about the drugs to the busy medical practitioner. The aim of current study was to assess drug promotional literatures as per world health organization, criteria and categorize them and to analyse the claims in presented in DPL.Methods: Current study is a descriptive study in which pharmaceutical promotional materials were collected from selected out-patient departments of a tertiary care hospital, Kurnool. Printed drug promotional literatures for modern drugs were collected and an assessment was made whether the advertisements adhered to WHO criteria for medicinal drug promotion.Results: A total of 271 drug promotional literatures were collected. Information about the single drug was given in 127 (46.9%). 144 (53.1%) DPLs contain fixed-dose combination. Majority of drug promoted in collected DPLs were miscellaneous group 83 (30.8%) followed by antimicrobials 55 (20.3%) and blood and cardiovascular drugs 37 (13.1), gastrointestinal drugs 23 (8.5%), drugs acting on endocrine system 23 (84.5%). Generic name was mentioned in 229 (84.5%) while brand name was mentioned in 271 (100%) of DPL.Conclusions: The study concluded that the drug information provided in the promotional brochures can be incomplete and unreliable. Hence a physician should not rely solely on the DPL provided by medical representatives. All brochures circulated among prescribers must undergo a strict process of assessment regarding information provided, especially related to efficacy and safety.

scholarly journals Hand hygiene compliance in Dutch general practice offices: an observational study.

2020 ◽  
Author(s):  
Nataliya Hilt ◽  
Mariëtte Lokate ◽  
Alfons OldeLoohuis ◽  
Marlies EJL Hulscher ◽  
Alex W Friedrich ◽  
...  
Keyword(s):  
Observational Study ◽  
Hand Hygiene ◽  
General Practitioners ◽  
Hand Hygiene Compliance ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
World Health ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Abstract Background Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline.Methods An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional.Results We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34%, 51% and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR).Conclusions HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.

scholarly journals Hand hygiene compliance in Dutch general practice offices

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Nataliya Hilt ◽  
Mariëtte Lokate ◽  
Alfons OldeLoohuis ◽  
Marlies E. J. L. Hulscher ◽  
Alex W. Friedrich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
General Practitioners ◽  
Hand Hygiene Compliance ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
World Health ◽  
Hand Wash ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Abstract Background Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline. Methods An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional. Results We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34, 51 and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR). The median time of disinfecting hands was 8 s (range 6–11 s) for HCWs in our study. Conclusions HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.

scholarly journals DRUG UTILIZATION STUDY IN POST-OPERATIVE PATIENTS IN THE SURGERY WARD OF A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

2018 ◽  
Vol 11 (12) ◽  
pp. 124
Author(s):  
Mohammad Arshad ◽  
Raghunandan M ◽  
Vasant R Chavan ◽  
Mohd Fayazuddin
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
General Pattern ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Case Record ◽  
Health Organization

Objectives: Pharmacotherapy with multiple agents before, during, and after surgery is marked in the present day indoor hospital setting. The main objective of our research is to evaluate the prescribing and drug utilization patterns using the World Health Organization (WHO) indicators in post-operative patients in the surgery ward of Raichur Institute of Medical Sciences (RIMS) teaching hospital - Raichur, which will help us to use the medicines rationally and decrease the adverse effects in surgical patients.Methods: A retrospective study was done on post-operative patients of surgery ward in RIMS teaching hospital - Raichur. A total of 574 patients prescriptions/case record forms were collected over a period of 15 months from January 2015 to March 2016 from the medical record section of the hospital for analysis and rationalization. We analyzed the data using the various drug use indicators given by the WHO.Results: The average number of drugs per encounter was 7.04. Ranitidine, analgesics, antibiotics, and intravenous fluids accounted for majority of the drugs prescribed. Appendicectomy (34.84%) was most commonly performed surgical procedure. Percentage of encounters in which an antibiotic prescribed was 99.8%. Percentage of encounters with an injection prescribed was 100%. Percentage of drugs prescribed by generic name was 43.93%. Percentage of drugs prescribed from National List of Essential Medicines 2015 was 99.3%.Conclusion: Our study gave us an in general pattern about the use of drugs in post-operative patients in the surgical ward of a tertiary care hospital. Widespread polypharmacy, particularly in case of the antibiotics, lack of generic prescribing are some concerns that need to be addressed to conform to rational drug therapy. However, prescribing according to the national essential list of medicines is good in our study.

The impact of a multimodel approach to designing a new orthopedic department

2020 ◽  
pp. 1-6
Author(s):  
Elad Keren ◽  
Abraham Borer ◽  
Lior Nesher ◽  
Tali Shafat ◽  
Rivka Yosipovich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Prevention Measures ◽  
Orthopedic Department ◽  
Before And After ◽  
The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

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