Highlights
- •A total of 1,007 opportunities for handrubs were recorded in the emergency department. Hand hygiene (HH) compliance increased significantly (P < .001) after the first intervention week to 40.5% (95% confidence interval [CI], 33%-48%) and stabilized (P = .075) after the second intervention week to 49.5% (95% CI, 43%-56%).
- •The total number of alcohol dispensers was increased from 25 to 55. Within every 5-m radius in the emergency department an alcohol dispenser was placed. Existing alcohol-based handrub was switched for a different brand for its proven skin friendliness.
- •Profession-specific analysis revealed a significant increase over the phases of the study in both subgroups, the physicians and nurses.
- •Regarding the frequency of hand hygiene indications, indication 4 (hand hygiene after touching a patient) composed most indications (31.6%). The increase of compliance applied for all indications; the highest and lowest relative improvements appeared to be indication 3, after contact with body fluids (700% of baseline), and indication 4, after patient contact (136% of baseline), respectively.
- •During the baseline observations, the effect of the time of day (day vs evening and week vs weekend) and the type of patient (surgical patients vs patients with infection vs others without infection) showed no significant effect on hand hygiene compliance.
Background
Hand hygiene (HH) is essential in preventing nosocomial infection. The emergency department
(ED) is an open portal of entry for pathogens into the hospital system, hence the
important sentinel function of the ED personnel. The main objective of this study
was to assess the effect of a multimodal improvement strategy on hand hygiene compliance
in the ED.
Methods
Our study was a prospective before-and-after study to determine the effect of a multimodal
improvement strategy on the compliance of HH in the ED according to the My 5 Moments
of Hand Hygiene defined by the World Health Organization. Interventions such as education,
reminders, and regular feedback on HH performance and role models were planned during
the 3 intervention weeks.
Results
In total, 57 ED nurses and ED physicians were observed in this study, and approximately
1,000 opportunities for handrubs were evaluated during the 3 intervention periods.
HH compliance increased significantly from baseline from 18% (74/407) to 41% (77/190)
after the first intervention and stabilized to 50% (99/200) and 46% (96/210) after
the second and third interventions, respectively.
Conclusions
Implementing a multimodal HH improvement program significantly improved the HH compliance
of ED personnel.
Key Words
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Article info
Publication history
Published online: May 07, 2016
Footnotes
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
