Research for infection protection
  • germs
  • Adenovirus
  • Aspergillus niger
  • Bovine virus diarrhea
  • Clostridium difficile
  • Candida albicans
  • Candida albicans
  • Coronavirus
  • Corynebacterium
  • Escherichia coli
  • Helicobacter pylori

Author: Rodriguez, V. / Giuffre, C. / Villa, S. / Almada, G. / Prasopa-Plaizier, N. / Gogna, M. / Gibbons, L. / García Elorrio, E. (2015) Source: Rodriguez, V. et al. A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial. International Journal for Quality in Health Care, 2015, 27(5): 405-411

STUDY

Rodriguez, V. / Giuffre, C. / Villa, S. / Almada, G. / Prasopa-Plaizier, N. / Gogna, M. / Gibbons, L. / García Elorrio, E. (2015)

A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial

Background: To prevent nosocomial infection hand disinfection is the most efficient and cost-effective method. Since 2005, WHO (World Health Organization) therefore has campaigned for hand hygiene – however, the compliance is often not satisfactory. Also intensive care units, where greatest caution should be exercised due to the weakened patients, are no exception to the rule: the compliance is often even worse here than in normal wards.
Hence, Rodriguez et al. conducted a randomised cluster-stepped wedge trial to investigate how a multimodal intervention influences the compliance in an Argentinian intensive care unit.


Method: First, Rodriguez et al. interviewed 38 nurses and physicians to detect specific obstacles and problems linked to compliance. Based on the interviews, the authors then developed a multimodal intervention that comprised the following five modules:

  1. a declaration of commitment by the management to support the intervention
  2. daily checks whether hand disinfectants and soaps are available
  3. use of eye-catching reminders
  4. introduction of a storyboard with the management’s declaration of commitment, monthly progress and photos of the healthcare workers
  5. provision of monthly progress reports for the facility’s coordinator, including comparisons with other participating facilities or international compliance rates.

During the study period of nine months between August 2011 and May 2012, the intervention was introduced in 11 differing wards at different time points. Uninvolved observers monitored the employees’ compliance following the 5 Moments of WHO. On three random days per week, at least 30 employees were observed for one hour.


Results: Before the intervention, the average hand hygiene compliance in the facilities was 62 %. Due to the intervention the individual wards were able to improve by up to 26.7 %. With the control group achieving a compliance of 66 %, the compliance after the intervention’s introduction increased to an average of 75.6 %.


Conclusion: With their study Rodriguez et al. could prove that a multimodal intervention can significantly increase the hand hygiene compliance in intensive care units: the participating wards were able to improve their compliance by up to 27 %.


Source:
Rodriguez, V. et al. A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial. International Journal for Quality in Health Care, 2015, 27(5): 405-411


Please click here to view the original study.


Additional information on hand hygiene programmes is available under CENTER.