Trial to Evaluate Effectiveness of Hand Hygiene Among Nurses

Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections, yet compliance rates are generally below 50 percent of all opportunities for hand hygiene. Anita Huis and colleagues at the Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre Nijmegen, The Netherlands announce a study that will evaluate the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses.

This study is a cluster randomized controlled trial with inpatient wards as the unit of randomization. Guidelines for hand hygiene will be implemented in this study. Two strategies will be used to improve the adherence to guidelines for hand hygiene. The state-of-the-art strategy is derived from the literature and includes education, reminders, feedback, and targeting adequate products and facilities. The extended strategy also contains activities aimed at influencing social influence in groups and enhancing leadership. The unique contribution of the extended strategy is built upon relevant behavioral science theories. The extended strategy includes all elements of the state-of-the-art strategy supplemented with gaining active commitment and initiative of ward management, modelling by informal leaders at the ward, and setting norms and targets within the team. Data will be collected at four points in time, with six-month intervals. An average of 3,000 opportunities for hand hygiene in approximately 900 nurses will be observed at each time point.

Performing and evaluating an implementation strategy that also targets the social context of teams may considerably add to the general body of knowledge in this field. Results from our study will allow us to draw conclusions on the effects of different strategies for the implementation of hand hygiene guidelines, and based on these results we will be able to define a preferred implementation strategy for hospital-based nursing.

Reference: Huis A, Schoonhoven L, Grol R, et al. Helping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses. Implementation Science 2011, 6:101 doi:10.1186/1748-5908-6-101. http://www.implementationscience.com/content/6/1/101