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Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe

Published online by Cambridge University Press:  02 January 2015

Victor D. Rosenthal
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Mandakini Pawar
Affiliation:
Pushpanjali Crosslay Hospital, Ghaziabad, India
Hakan Leblebicioglu
Affiliation:
Ondokuz Mayis University Medical School, Samsun, Turkey
Josephine Anne Navoa-Ng
Affiliation:
St. Luke's Medical Center, Quezon City, Philippines
Wilmer Villamil-Gómez
Affiliation:
Clínica Santa María, Sucre, Colombia
Alberto Armas-Ruiz
Affiliation:
Centro Médico La Raza IMSS, Mexico City, Mexico
Luis E. Cuéllar
Affiliation:
Instituto Nacional de Enfermedades Neoplásias, Lima, Peru
Eduardo A. Medeiros
Affiliation:
Hospital São Paulo, São Paulo, Brazil
Zan Mitrev
Affiliation:
Special Hospital for Surgical Disease “Filip Vtori, ” Skopje, Macedonia
Achilleas Gikas
Affiliation:
University Hospital of Heraklion, Heraklion, Greece
Yun Yang
Affiliation:
Shanxi Dayi Hospital, Tai Yuan, China
Altaf Ahmed
Affiliation:
Indus Hospital, Karachi, Pakistan
Souha S. Kanj
Affiliation:
American University of Beirut Medical Center, Beirut, Lebanon
Lourdes Dueñas
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
Vaidotas Gurskis
Affiliation:
Pediatric Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania
Trudell Mapp
Affiliation:
Clínica Hospital San Fernando, Panama City, Panama
Humberto Guanche-Garcell
Affiliation:
Hospital Docente Clínico Quirúrgico “Joaquín Albarrán Domínguez, ” Havana, Cuba
Rosalía Fernández-Hidalgo
Affiliation:
Hospital Clínica Bíblica, San José, Costa Rica
Andrzej Kübler
Affiliation:
University Hospital of Wroclaw, Wroclaw, Poland
Corresponding
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Abstract

Objective.

To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multi-dimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.

Design.

An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.

Setting.

Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.

Participants.

Healthcare workers at 99 ICU members of the INICC.

Methods.

A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.

Results.

A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P<.001), physicians versus nurses (62% vs 72%; P<.001), and adult versus neonatal ICUs (67% vs 81%; P<.001), among others.

Conclusions.

Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

References

1.Raju, TN. Ignác Semmelweis and the etiology of fetal and neonatal sepsis. J Perinatol 1999;19(4):307310.CrossRefGoogle ScholarPubMed
2.Simmons, B, Bryant, J, Neiman, K, Spencer, L, Arheart, K. The role of handwashing in prevention of endemic intensive care unit infections. Infect Control Hosp Epidemiol 1990;11(11):589594.CrossRefGoogle ScholarPubMed
3.Rosenthal, VD, Guzman, S, Safdar, N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. Am J Infect Control 2005;33(7):392397.CrossRefGoogle ScholarPubMed
4.Pittet, D, Allegranzi, B, Boyce, J; World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts. The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations. Infect Control Hosp Epidemiol 2009;30(7):611622.CrossRefGoogle ScholarPubMed
5.Jarvis, WR. Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention. Infect Control Hosp Epidemiol 1996;17(8):552557.CrossRefGoogle Scholar
6.Safdar, N, Crnich, CJ, Maki, DG. Nosocomial infections in the intensive care unit associated with invasive medical devices. Curr Infect Dis Rep 2001;3(6):487495.CrossRefGoogle ScholarPubMed
7.Rosenthal, VD, Maki, DG, Graves, N. The International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control 2008;36(9):e1e12.CrossRefGoogle ScholarPubMed
8.Rosenthal, VD, Maki, DG, Salomao, R, et al.Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 2006;145(8):582591.CrossRefGoogle ScholarPubMed
9.Rosenthal, VD, Maki, DG, Mehta, A, et al.International Nosocomial Infection Control Consortium report, data summary for 2002–2007, issued lanuary 2008. Am J Infect Control 2008;36(9):627637.CrossRefGoogle ScholarPubMed
10.Rosenthal, VD, Maki, DG, Jamulitrat, S, et al.International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003–2008, issued June 2009. Am J Infect Control 2010;38(2):95104.e2.CrossRefGoogle ScholarPubMed
11.Rosenthal, VD, Bijie, H, Maki, DG, et al.International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004–2009. Am J Infect Control 2012;40(5):396407.CrossRefGoogle ScholarPubMed
12.Lam, BC, Lee, J, Lau, YL. Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection. Pediatrics 2004;114(5):e565e571.CrossRefGoogle Scholar
13.Rosenthal, VD, McCormick, RD, Guzman, S, Villamayor, C, Orellano, PW. Effect of education and performance feedback on handwashing: the benefit of administrative support in Argentinean hospitals. Am J Infect Control 2003;31(2):8592.CrossRefGoogle ScholarPubMed
14.Allegranzi, B, Sax, H, Bengaly, L, et al.Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol 2010;31(2):133141.CrossRefGoogle Scholar
15.Preston, GA, Larson, EL, Stamm, WE. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med 1981;70(3):641645.CrossRefGoogle Scholar
16.Conly, JM, Hill, S, Ross, J, Lertzman, J, Louie, TJ. Handwashing practices in an intensive care unit: the effects of an educational program and its relationship to infection rates. Am J Infect Control 1989;17(6):330339.CrossRefGoogle Scholar
17.Mayer, JA, Dubbert, PM, Miller, M, Burkett, PA, Chapman, SW. Increasing handwashing in an intensive care unit. Infect Control 1986;7(5):259262.CrossRefGoogle Scholar
18.Larson, EL, Bryan, JL, Adler, LM, Blane, C. A multifaceted approach to changing handwashing behavior. Am J Infect Control 1997;25(1):310.CrossRefGoogle ScholarPubMed
19.Graham, M. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control 1990;18(2):7781.CrossRefGoogle Scholar
20.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(4):191193.CrossRefGoogle Scholar
21.Dorsey, ST, Cydulka, RK, Emerman, CL. Is handwashing teachable? failure to improve handwashing behavior in an urban emergency department. Acad Emerg Med 1996;3(4):360365.CrossRefGoogle Scholar
22.Boyce, JM, Pittet, D; Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16):145.Google Scholar
23.WHO launches global patient safety challenge; issues guidelines on hand hygiene in health care. Indian J Med Sci 2005;59(10):461463.Google Scholar
24.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36(5):309332.CrossRefGoogle ScholarPubMed
25.Guinan, ME, McGuckin-Guinan, M, Sevareid, A. Who washes hands after using the bathroom? Am J Infect Control 1997;25(5):424425.CrossRefGoogle Scholar
26.Haley, RW, Bregman, DA. The role of understaffing and over-crowding in recurrent outbreaks of staphylococcal infection in a neonatal special-care unit. J Infect Dis 1982;145(6):875885.CrossRefGoogle Scholar
27.Watanakunakorn, C, Wang, C, Hazy, J. An observational study of hand washing and infection control practices by healthcare workers. Infect Control Hosp Epidemiol 1998;19(11):858860.CrossRefGoogle Scholar
28.Lipsett, PA, Swoboda, SM. Handwashing compliance depends on professional status. Surg Infect (Larchmt) 2001;2(3):241245.CrossRefGoogle ScholarPubMed
29.Bischoff, WE, Reynolds, TM, Sessler, CN, Edmond, MB, Wenzel, RP. Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160(7):10171021.CrossRefGoogle ScholarPubMed
30.Deming, W. Out of the Crisis. Boston: MIT Press, 1986.Google Scholar
31.Rosenthal, VD, Guzman, S, Pezzotto, SM, Crnich, CJ. Effect of an infection control program using education and performance feedback on rates of intravascular device–associated bloodstream infections in intensive care units in Argentina. Am J Infect Control 2003;31(7):405409.CrossRefGoogle ScholarPubMed
32.Rosenthal, VD, Guzman, S, Safdar, N. Effect of education and performance feedback on rates, of catheter-associated urinary tract infection in intensive care units in Argentina. Infect Control Hosp Epidemiol 2004;25(1):4750.CrossRefGoogle ScholarPubMed
33.Rosenthal, VD, Guzman, S, Crnich, C. Impact of an infection control program on rates of ventilator-associated pneumonia in intensive care units in 2 Argentinean hospitals. Am J Infect Control 2006;34(2):5863.CrossRefGoogle ScholarPubMed
34.Rosenthal, VD, Maki, DG, Rodrigues, C, et al.Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line–associated bloodstream infection rates in the intensive care units of 15 developing countries. Infect Control Hosp Epidemiol 2010;31(12):12641272.CrossRefGoogle ScholarPubMed
35.Rosenthal, VD, Todi, SK, Álvarez-Moreno, C, et al.Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection 2012;40(5):517526.CrossRefGoogle Scholar
36.Rosenthal, VD, Rodrigues, C, Álvarez-Moreno, C, et al.Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14 developing countries of 4 continents: findings of the International Nosocomial Infection Control Consortium (INICC). Crit Care Med 2012;40(12):31213128.CrossRefGoogle Scholar
37.Rosenthal, VD, Ramachandran, B, Villamil-Gómez, W, et al.Impact of a multidimensional infection control strategy on central line–associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection 2012;40(4):415423.CrossRefGoogle Scholar
38.Rosenthal, VD, Ramachandran, B, Dueñas, L, et al.Findings of the International Nosocomial Infection Control Consortium (INICC), part I: effectiveness of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries. Infect Control Hosp Epidemiol 2012;33(7):696703.CrossRefGoogle ScholarPubMed
39.Rosenthal, VD, Álvarez-Moreno, C, Villamil-Gómez, W, et al.Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings. Am J Infect Control 2012;40(6):497501.CrossRefGoogle ScholarPubMed
40.Rosenthal, VD, Rodríguez-Calderón, ME, Rodríguez-Ferrer, M, et al.Findings of the International Nosocomial Infection Control Consortium (INICC), part II: impact of a multidimensional strategy to reduce ventilator-associated pneumonia in neonatal intensive care units in 10 developing countries. Infect Control Hosp Epidemiol 2012;33(7):704710.CrossRefGoogle ScholarPubMed

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