Highlights
- •A multifaceted hand hygiene intervention specifically designed for nursing homes was assessed.
- •Mortality was found to be significantly lower in intervention nursing homes.
- •No impact was found on hospitalization rates.
Background
The aim of this study was to assess the impact of a multifaceted hand hygiene (HH)
program on the infectious risk in nursing homes (NHs).
Methods
This was a 2-arm cluster randomized trial; French NHs were allocated randomly to the
intervention (13 NHs) or control (13 NHs) groups. The intervention consisted of implementing
a bundle of HH-related measures over 1 year, including increased availability of alcohol-based
handrub, HH promotion, staff education, and local work groups. The primary end point
was the incidence rate of acute respiratory infections and gastroenteritis reported
in the context of clustered cases episodes. Secondary end points were mortality, hospitalization,
and antibiotic prescription rates.
Results
Baseline characteristics did not differ between groups. The overall handrub consumption
was higher in the intervention group over the 1-year intervention period. Because
of underreporting, data on the primary end points were of insufficient quality for
analysis. Hospitalizations did not differ between the 2 groups. However, the intervention
group showed significantly lower mortality (2.10 vs 2.65 per 100 residents per month,
respectively; P = .003) and antibiotic prescriptions (5.0 vs 5.8 defined daily doses per 100 resident
days, respectively; P < .001). These results were confirmed by the longitudinal multivariate analysis adjusted
for NH and resident characteristics and for seasonality (mortality rate ratio, 0.76).
Conclusions
A multifaceted HH intervention may have a short-term impact on mortality in NHs. Nevertheless,
other strategies may remain necessary to reduce morbidity.
Key Words
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Article Info
Publication History
Published online: October 05, 2017
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
