Highlights
- •Implementation of multimodal infection control strategies was assessed in Greece.
- •Systematic situation analysis of hand hygiene practices in 17 acute-care hospitals.
- •Greek hospitals are, on average, at an intermediate level in hand hygiene practice.
- •Training, feedback and safety climate for hand hygiene require improvements.
- •Infection control nurse staffing levels significantly affect implementation progress.
Background
In this first attempt to suggest achievable standards for improvement in hospital
infection prevention and control (IPC) in Greece, we assessed main IPC structure and
process indicators emphasizing hand hygiene.
Methods
Acute-care hospitals across the country participated in a cross-sectional survey by
completing the World Health Organization Hand Hygiene Self-assessment Framework (HHSAF)
and by providing hospital-level IPC indicators.
Results
Seventeen hospitals completed the survey, comprising 14% of the country's public hospitals.
Median IPC staffing levels were 0.8 nurses and 0.5 doctors per 250 beds. Few hospitals
implemented full multimodal IPC programs. The HHSAF indicated that appropriate hand
hygiene practices and promotion strategies were in place in most hospitals, but the
mean HHSAF score of 289 was lower compared with studies in Italy (mean, 332; P = .040) and the United States (mean, 373; P < .001). Presence of 1 additional IPC nurse was independently associated with increases
of 53% in the HHSAF median score for training-education (P = .035) and by 38% in the lower 30th percentile HHSAF score for safety climate (P = .049).
Conclusions
Surveyed hospitals are, on average, at an intermediate level in hand hygiene practice
but require improvements on training-education, evaluation-feedback, and safety climate.
Ensuring adequate IPC nurse staffing levels and systematically implementing multimodal
IPC programs may lead to substantial improvements.
Key Words
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Article info
Publication history
Published online: May 17, 2018
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.
