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Workers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Esther van der Meer of the Department of Public and Occupational Health at the EMGO Institute for Health and Care Research in Amsterdam, and colleagues, report on a multi-faceted implementation strategy (MIS) that will be developed to implement these recommendations to reduce hand eczema among healthcare workers performing wet work.
The study will be a randomized controlled trial in three university hospitals in the Netherlands. Randomization to the control or intervention group will be performed at department level. The control group will receive a leaflet containing the recommendations only. The intervention group will receive the MIS which consists of five parts: 1) within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2) role models will help their colleagues in performing the desired behavior; 3) education to all workers will enhance knowledge about (the prevention of) hand eczema; 4) reminders will be placed at the department reminding workers to use the recommendations; 5) workers receive the same leaflet as the control group containing the recommendations.
Data will be collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure will be self-reported hand eczema. The most important secondary outcome measures will be symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and healthcare costs. Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employer's perspective.
The researchers say that prevention of hand eczema is important for the hospital environment and if the MIS proves to be effective, a major improvement in the health of healthcare workers can be obtained. Results are expected in 2014; the trial registration number is NTR2812. Their study was discussed in BMC Public Health.
Reference: van der Meer EWC, et al. Hands4U: A multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in healthcare workers: design of a randomized controlled trial and (cost) effectiveness evaluation. BMC Public Health 2011, 11:669doi:10.1186/1471-2458-11-669.