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Behavior-Based Interventions to Improve Hand Hygiene Adherence Among Intensive Care Unit Healthcare Workers in Thailand

Published online by Cambridge University Press:  04 February 2015

Anucha Apisarnthanarak ,
Thanee Eiamsitrakoon  and
Linda M. Mundy
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Thanee Eiamsitrakoon
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Linda M. Mundy
Affiliation:
GlaxoSmithKline, Collegeville, Pennsylvania
*
Address correspondence to Anucha Apisarnthanarak, MD, Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand, 10120 (anapisarn@yahoo.com).
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Abstract

OBJECTIVE

To evaluate behavioral-based interventions to improve hand hygiene (HH) among healthcare workers (HCWs) at a Thai tertiary care center.

METHODS

A quasi-experimental study was performed in 6 intensive care units with computer-generated allocation. Baseline demographic characteristics, self-reported stage of HH behavioral commitment, and observed HH adherence were examined from January 1, 2012, through December 31, 2012 (preintervention), and from January 1, 2013, through December 31, 2013 (postintervention). Self-reported HH was categorized by the stages construct from the Transtheoretical Model of Health Behavior Change. The intensive care unit group randomization was to either standard-of-care HH education every 3 months (S1), intensified HH interventions (S2), or intensified HH interventions plus increased availability of alcohol-based handrub throughout the unit (S3).

RESULTS

Among125 HCWs from 6 intensive care units (42 in S1, 41 in S2, 42 in S3) there were 1,936 total HH observations; most HCWs (100 [ 80%]) were nurses or nurse assistants. Compared with preintervention, overall postintervention HH adherence improved in HCWs assigned to S2 (65% vs 85%; P=.02) and S3 (66% vs 95%; P=.005) but not S1 (68% vs 71%; P=.84). Improvement in HH adherence was demonstrated among HCWs who reported lower stages of HH commitment in S2 (21% vs 84%; P<.001) and S3 (24% vs 89%; P<.001) and in HCWs who self-reported higher stages of commitment in S3 (78% vs 96%; P<.001).

CONCLUSIONS

HCW HH programs may benefit from stage-based tailored strategies to promote sustained HH adherence.

Infect Control Hosp Epidemiol 2015;00(0): 1–5

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 5 , May 2015 , pp. 517 - 521
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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