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Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland

Published online by Cambridge University Press:  13 September 2017

Anthony Staines ,
Isabelle Amherdt ,
Estelle Lécureux ,
Christiane Petignat ,
Philippe Eggimann ,
Marcos Schwab  and
Didier Pittet
Anthony Staines*
Affiliation:
Hospital Federation of Vaud, Prilly, Switzerland Institute for Education and Research on Social and Health Organizations (IFROSS), University of Lyon 3, Lyon, France
Isabelle Amherdt
Affiliation:
Hospital Federation of Vaud, Prilly, Switzerland
Estelle Lécureux
Affiliation:
Stat’Elite, Nyon, Switzerland
Christiane Petignat
Affiliation:
Hospital Preventive Medicine Service, CHUV University Hospital, Lausanne, Switzerland
Philippe Eggimann
Affiliation:
Department of Adult Intensive Care Medicine, CHUV University Hospital, Lausanne, Switzerland University of Lausanne, Lausanne, Switzerland
Marcos Schwab
Affiliation:
Department of Internal Medicine, GHOL Hospital, Nyon, Switzerland
Didier Pittet
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
*
Address correspondence to Anthony Staines, PhD, Hospital Federation of Vaud, Bois de Cery, 1008 Prilly, Switzerland (anthony.staines@bluewin.ch).
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Abstract

OBJECTIVE

To assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative.

DESIGN

Multicenter analysis of hand hygiene compliance through direct observation by trained observers.

SETTING

A total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland.

PARTICIPANTS

Clinical staff.

INTERVENTIONS

In total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449–6,852). An 18-month Hand Hygiene Breakthrough Collaborative was conducted to implement the WHO multimodal promotional strategy including improved access to alcohol-based hand rub, education, performance measurement and feedback, reminders and communication, leadership engagement, and safety culture.

RESULTS

Overall hand hygiene compliance improved from 61.9% to 88.3% (P<.001) over 18 months and was sustained at 88.9% (P=.248) 12 months after the intervention. Hand hygiene compliance among physicians increased from 62% to 85% (P<.001) and finally 86% at follow-up (P=.492); for nursing staff, compliance improved from 64% to 90% (P<.001) and finally 90% at follow-up (P=.464); for physiotherapists compliance improved from 50% to 90% (P<.001) and finally 91% at follow-up (P=.619); for X-ray technicians compliance improved from 45% to 80% (P<.001) and finally 81% at follow-up (P=.686). Hand hygiene compliance also significantly increased with sustained improvement across all hand hygiene indications and all hospitals.

CONCLUSIONS

A rigorously conducted multicenter project combining the Breakthrough Collaborative method for its structure and the WHO multimodal strategy for content and measurement was associated with significant and substantial improvement in compliance across all professions, all hand hygiene indications, and all participating hospitals.

Infect Control Hosp Epidemiol 2017;38:1420–1427

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 12 , December 2017 , pp. 1420 - 1427
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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