Research for infection protection
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  • Aspergillus niger
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  • Clostridium difficile
  • Candida albicans
  • Candida albicans
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  • Escherichia coli
  • Helicobacter pylori

Author: Schwadtke, L. / Graf K / Lutze, B. / Von Lengerke, T. / Chaberny, I. (2014 ) Source: Schwadtke et al., 2014, Deutsche Medizinische Wochenschrift, Vol: 139

STUDY

Schwadtke, L. / Graf K / Lutze, B. / Von Lengerke, T. / Chaberny, I. (2014 )

Interventions improve hand hygiene compliance significantly – but only for a short time

Background: One of the most important preventive measures to efficiently avoid nosocomial infection is alcohol-based hand disinfection. In many places, the low hand hygiene compliance could be recorded in a standardised manner and at least improved for a short time by implementing the German “Aktion Saubere Hände” (Clean Hands Campaign). The sustainability of the effect is, however, still unclear. Hence, Schwadtke et al. investigated what long-term influence the “Aktion Saubere Hände” campaign had on the compliance of medical and nursing staff of intensive care units (ICU) and hematopoietic stem cell transplantation units (HSCTU) at Hannover Medical School.


Methods:
Schwadtke et al. conducted behavioural observations in accordance with WHO. The compliance of physicians and nurses in ten ICUs and two HSCTUs was recorded over six years in the framework of the “Aktion Saubere Hände” campaign. Standardised record sheets were used for the documentation, which was done per ward. The occupational groups were differentiated.


Results: From 2008 until 2013, nine trained employees observed a total of 13 175 hand hygiene opportunities in the ten ICUs and the two HSCTUs at Hannover Medical School. One opportunity corresponded to one of WHO’s five hand disinfection indications. The recorded hand disinfection opportunities were attributable to a total of 293 employees: 67 physicians and 226 nurses. Around 18 % (2 409 opportunities) were attributable to physicians.
At the beginning of the campaign, physicians had a compliance of 53 %. Until 2011, this rate increased by 11 % to 64 %. In the following two years until 2013, the compliance fell below the initial value to 48.4 %.
Nurses started with a compliance rate of 57 % and increased it in the framework of the campaign to 71 % until 2009/2010. Until 2013, this improvement declined again and fell below the initial value to 55.8 %.


Conclusions:
The development of the compliance rates among both occupational groups shows that the compliance could not be increased sustainably by the “Aktion Saubere Hände” campaign. After an initial considerable increase, the compliance decreased drastically over the study period to values below the baseline level. This lack of sustainability shows that die promotion of hygienic hand disinfection is a continual challenge, but not a one-time campaign, and should be defined as permanent task.
As the compliance rates were different among the two occupational groups of physicians and nurses, the authors conclude that future interventions should address employees both in a ward-specific and occupational group-specific fashion.


Source:
Schwadtke et al., 2014, Deutsche Medizinische Wochenschrift, Vol: 139


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