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Handwashing Program for the Prevention of Nosocomial Infections in a Neonatal Intensive Care Unit

  • Sau-Pin Won (a1), Hung-Chieh Chou (a1), Wu-Shiun Hsieh (a1), Chien-Yi Chen (a1), Shio-Min Huang (a1), Kuo-Inn Tsou (a2) and Po-Nien Tsao (a1)...

Abstract

Objective:

To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).

Design:

Open trial.

Setting:

A level-III NICU in a teaching hospital.

Participants:

Nurses, physicians, and other healthcare workers in the NICU.

Interventions:

A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.

Results:

Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P = .003) with improved handwashing compliance. In particular, respiratory tract infections decreased from 3.35 to 1.06 per 1,000 patient-days during the handwashing campaign (P = .002). Furthermore, the correlation between nosocomial infection of the respiratory tract and handwashing compliance also reached statistical significance (r = -0.385; P = .014).

Conclusions:

Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU

Copyright

Corresponding author

Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan

References

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1.Hemming, VG, Overall, JC Jr, Britt, MR. Nosocomial infections in a newborn intensive-care unit: results of forty-one months of surveillance. N Engl J Med 1976;294:13101316.
2.Goldman, DA. Prevention and management of neonatal infections. Infect Dis Clin North Am 1989;3:779813.
3.Sohn, AH, Garrett, DO, Sinkowitz-Cochran, RL, et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001;139:821827.
4.Lee, SK, McMillan, DD, Ohlsson, A, et al.Variations in practice and outcomes in the Canadian NICU network: 1996-1997. Pediatrics 2000; 106:10701079.
5.Baltimore, RS. Neonatal nosocomial infections. Semin Perinatal 1998; 22:2532.
6.Foca, M, Jakob, K, Whittier, S, et al.Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000;343:695700.
7.Pittet, D, Dharan, S, Touveneau, S, Sauvan, V, Perneger, TV. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 1999;159:821826.
8.Garner, JS, Simmons, BS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231243.
9.Adams-Chapman, I, Stoll, BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr 2002;14:157164.
10.Doebbeling, BN, Stanley, GL, Sheetz, CT, et al.Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N Engl J Med 1992;327:8893.
11.Yu, VY. Neonatal sepsis and infection control policies in Australia. J Paediatr Child Health 1990;26:252256.
12.Sharek, PJ, Benitz, WE, Abel, NJ, Freeburn, MJ, Mayer, ML, Bergman, DA. Effect of an evidence-based hand washing policy on hand washing rates and false-positive coagulase negative staphylococcus blood and cerebrospinal fluid culture rates in a level III NICU. J Perinatal 2002;22:137143.
13.Larson, EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251269.
14.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.
15.Bittner, MJ, Rich, EC, Turner, PD, Arnold, WH Jr.Limited impact of sustained simple feedback based on soap and paper towel consumption on the frequency of hand washing in an adult intensive care unit. Infect Control Hosp Epidemiol 2002;23:120126.
16.Pittet, D. Promotion of hand hygiene: magic, hype, or scientific challenge? Infect Control Hosp Epidemiol 2002;23:118119.
17.Larson, E, Kretzer, EK. Compliance with handwashing and barrier precautions. J Hosp Infect 1995;30(suppl):88106.
18.Pittet, D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000;21:381386.
19.Albert, RK, Condie, F. Hand-washing patterns in medical intensive-care units. N Engl J Med 1981;304:14651466.
20.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126130.
21.Dubbert, PM, Dolce, J, Richter, W, Miller, M, Chapman, SW. Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol 1990;11:191193.

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Handwashing Program for the Prevention of Nosocomial Infections in a Neonatal Intensive Care Unit

  • Sau-Pin Won (a1), Hung-Chieh Chou (a1), Wu-Shiun Hsieh (a1), Chien-Yi Chen (a1), Shio-Min Huang (a1), Kuo-Inn Tsou (a2) and Po-Nien Tsao (a1)...

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