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A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance

  • Manon D. van Dijk (a1), Sanne A. Mulder (a2), Vicki Erasmus (a2), A. H. Elise van Beeck (a2), Joke M. J. J. Vermeeren (a3), Xiaona Liu (a2), Ed F. van Beeck (a2) and Margreet C. Vos (a1)...

Abstract

Objective

To investigate the effects of friendly competition on hand hygiene compliance as part of a multimodal intervention program.

Design

Prospective observational study in which the primary outcome was hand hygiene compliance. Differences were analyzed using the Pearson χ2 test. Odds ratios (ORs) with 95% confidence interval were calculated using multilevel logistic regression.

Setting

Observations were performed in 9 public hospitals and 1 rehabilitation center in Rotterdam, Netherlands.

Participants

From 2014 to 2016, at 5 time points (at 6-month intervals) in 120 hospital wards, 20,286 hand hygiene opportunities were observed among physicians, nurses, and other healthcare workers (HCWs).

Intervention

The multimodal, friendly competition intervention consisted of mandatory interventions: monitoring and feedback of hand hygiene compliance and optional interventions (ie, e-learning, kick-off workshop, observer training, and team training). Hand hygiene opportunities, as formulated by the World Health Organization (WHO), were unobtrusively observed at 5 time points by trained observers. Compliance data were presented to the healthcare organizations as a ranking.

Results

The overall mean hand hygiene compliance at time point 1 was 42.9% (95% confidence interval [CI], 41.4–44.4), which increased to 51.4% (95% CI, 49.8–53.0) at time point 5 (P<.001). Nurses showed a significant improvement between time points 1 and 5 (P<.001), whereas the compliance of physicians and other HCWs remained unchanged. In the multilevel logistic regressions, time points, type of ward, and type of HCW showed a significant association with compliance.

Conclusion

Between the start and the end of the multimodal intervention program in a friendly competition setting, overall hand hygiene compliance increased significantly.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. All rights reserved.

Corresponding author

Author for correspondence: Prof Dr Margreet C. Vos, Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. E-mail: m.vos@erasmusmc.nl

Footnotes

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a

Authors of equal contribution.

Cite this article: van Dijk M D, et al. (2019). A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance. Infection Control & Hospital Epidemiology 2019, 40, 187–193. doi: 10.1017/ice.2018.261

PREVIOUS PRESENTATION. The results of this study were presented at the 22nd International Forum on Quality and Safety in Healthcare by Joke M. J. J. Vermeeren on April 26–28, 2017, in London, United Kingdom. The results of this manuscript were also presented as a poster presentation (abstract no. 6225) by Manon D. van Dijk at the 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) on April 21–24, 2018, in Madrid, Spain.

Footnotes

References

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A multimodal regional intervention strategy framed as friendly competition to improve hand hygiene compliance

  • Manon D. van Dijk (a1), Sanne A. Mulder (a2), Vicki Erasmus (a2), A. H. Elise van Beeck (a2), Joke M. J. J. Vermeeren (a3), Xiaona Liu (a2), Ed F. van Beeck (a2) and Margreet C. Vos (a1)...

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