Experts from São Paulo, Brazil say that the WHO Hand Hygiene (HH) Improvement Strategy Program has been implemented mostly in inpatient units, and they report on their experience with implementing this strategy in inpatient and outpatient units.
Their program was conducted in a 500-bed private hospital in São Paulo, Brazil. The WHO tool was used to assess HH adherence before (Jun-Aug 2008) and after the intervention (Jul-Sept 2009). The inpatient units consisted of the medical/surgical ward, oncology, neonatal and pediatrics; the outpatient units consisted of surgical ambulatory, obstetric center, emergency, post-anesthesia, diagnostic medicine department and dialysis center. Several strategies were applied campaigns, behavioral methods, and educational programs. More dispensers of alcohol-based product were made available in areas of the hospital such as restaurants, cafeterias, waiting rooms, lounges, receptions and next to elevators.
In inpatient units, the overall HH adherence improved 30.8 percent, from 63.8 percent (1,433/2,248 opportunities) to 83.5 percent (2,144/2,567 opportunities). In outpatient units it improved 53.2 percent, from 39.5 percent (679/1721 opportunities) to 60.4 percent (1,044/1,728 opportunities). The only exception in HH improvement was physician (no increase in inpatient unit) and obstetric center (5 percent decrease).
Kawagoe, et al. conclude that the higher HH compliance was in inpatient units, although there was a significant improvement in outpatient units. They add that infection prevention strategies such as HH must be developed and applied according to the needs of inpatient and outpatient units. Their research was presented at the International Conference on Prevention & Infection Control (ICPIC) held in Geneva, Switzerland June 29-July 2, 2011.
Reference: JY Kawagoe, CV Silva, MF Cardoso, P Gonçalves, MG Ballalai, AR Toniolo, CB DalForno, ST Valerio, EAA Reis, LG Pontes, LB Cunha and L Correa. The challenges of hand hygiene improvement: a comparison between inpatient and outpatient units. Presentation at International Conference on Prevention & Infection Control (ICPIC). BMC Proceedings 2011, 5(Suppl 6):P110doi:10.1186/1753-6561-5-S6-P110