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J Hosp Med. Improving Hand Hygiene Adherence in Healthcare Workers Before Patient Contact: A Multimodal Intervention in Four Tertiary Care Hospitals

tetano

Editor, Senior Moderator
J Hosp Med. 2020 May;15(5):262-267. doi: 10.12788/jhm.3446.
Improving Hand Hygiene Adherence in Healthcare Workers Before Patient Contact: A Multimodal Intervention in Four Tertiary Care Hospitals in Japan.


Saitoh A[SUP]1[/SUP], Sato K[SUP]2[/SUP], Magara Y[SUP]2[/SUP], Osaki K[SUP]3[/SUP], Narita K[SUP]4[/SUP], Shioiri K[SUP]5[/SUP], Fowler KE[SUP]6[/SUP], Ratz D[SUP]6[/SUP], Saint S[SUP]6,[/SUP][SUP]7[/SUP].

Author information




Abstract

BACKGROUND:

Hand hygiene is key to preventing healthcare-associated infection and the spread of respiratory viruses like the novel coronavirus that causes COVID-19. Unfortunately, hand hygiene adherence of healthcare workers (HCWs) in Japan is suboptimal according to previous studies.
OBJECTIVES:

Our objectives were to evaluate hand hygiene adherence among physicians and nurses before touching hospitalized patients and to evaluate changes in hand hygiene adherence after a multimodal intervention was implemented.
DESIGN, SETTING, AND PARTICIPANTS:

We conducted a pre- and postintervention study with HCWs at four tertiary hospitals in Niigata, Japan. Hand hygiene observations were conducted from June to August 2018 (preintervention) and February to March 2019 (postintervention).
INTERVENTION:

The multimodal hand hygiene intervention recommended by the World Health Organization was tailored to each hospital and implemented from September 2018 to February 2019.
MAIN OUTCOMES AND MEASURES:

We observed hand hygiene adherence before touching patients in each hospital and compared rates before and after intervention. Intervention components were also evaluated.
RESULTS:

There were 2,018 patient observations preintervention and 1,630 postintervention. Overall, hand hygiene adherence improved from 453 of 2,018 preintervention observations (22.4%) to 548 of 1,630 postintervention observations (33.6%; P < .001). Rates improved more among nurses (13.9 percentage points) than among doctors (5.7 percentage points). Improvement varied among the hospitals: Hospital B (18.4 percentage points) was highest, followed by Hospitals D (11.4 percentage points), C (11.3 percentage points), and Hospital A (6.5 percentage points).
CONCLUSIONS:

A multimodal intervention improved hand hygiene adherence rates in physicians and nurses in Niigata, Japan; however, further improvement is necessary. Given the current suboptimal hand hygiene adherence rates in Japanese hospitals, the spread of COVID-19 within the hospital setting is a concern.



PMID:32379022DOI:10.12788/jhm.3446
 
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