Multi-modal Infection Prevention Program Boosts Hand Hygiene Compliance

Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor. Hanan Aboumatar MD, MPH, of the Center for Innovation in Quality Patient Care, Johns Hopkins Medicine in Baltimore, and colleagues, sought to assess short- and long-term effects of an infection prevention promotion program on healthcare workers' hand hygiene behaviors. Their study was conducted at a tertiary-care academic center.

The researchers developed a multi-modal program that included a multimedia communications campaign, education, leadership engagement, environment modification, team performance measurement and feedback. Healthcare workers' hand hygiene practices were measured via direct observations over a three-year period by undercover observers.

Overall hand hygiene compliance increased by two-fold after full program implementation, and this increase was sustained over a 20-month follow-up period, the researchers report. The odds for compliance with hand hygiene increased by 3.8-fold in the six months after full program implementation, and this increase was sustained. There was even a modest increase at 20 months of follow-up. Hand hygiene compliance increased among all disciplines and hospital units.

According to the researchers, hand hygiene compliance increased from 35 percent in the first six months after program initiation to 77 percent in the last six months of the study period among nursing providers; from 38 percent to 62 percent among medical providers; and from 27 percent to 75 percent among environmental services staff.

The researchers concluded that implementation of the infection prevention promotion program was associated with a significant and sustained increase in hand hygiene practices among healthcare personnel of various disciplines.

Reference: Aboumatar H, et al. Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel. Infect Control Hosp Epidem. February 2012.