Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-20T03:05:50.062Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 January 2015

Sau-Pin Won ,
Hung-Chieh Chou ,
Wu-Shiun Hsieh ,
Chien-Yi Chen ,
Shio-Min Huang ,
Kuo-Inn Tsou  and
Po-Nien Tsao
Sau-Pin Won
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
Hung-Chieh Chou
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
Wu-Shiun Hsieh
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
Chien-Yi Chen
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
Shio-Min Huang
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
Kuo-Inn Tsou
Affiliation:
Department of Pediatrics, Cardinal Tien Hospital andFu-Jen Catholic University, Taipei, Taiwan
Po-Nien Tsao*
Affiliation:
Departments of Pediatrics and Nursing, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
*
Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
Get access Rights & Permissions [Opens in a new window]

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

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 742 - 746
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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;294:1310–1316.Google Scholar
2.Goldman, DA. Prevention and management of neonatal infections. Infect Dis Clin North Am 1989;3:779–813.Google Scholar
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;139:821–827.Google Scholar
4.Lee, SK, McMillan, DD, Ohlsson, A, et al.Variations in practice and outcomes in the Canadian NICU network: 1996-1997. Pediatrics 2000; 106:1070–1079.Google Scholar
5.Baltimore, RS. Neonatal nosocomial infections. Semin Perinatal 1998; 22:25–32.Google Scholar
6.Foca, M, Jakob, K, Whittier, S, et al.Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000;343:695–700.CrossRefGoogle Scholar
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;159:821–826.Google Scholar
8.Garner, JS, Simmons, BS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231–243.Google Scholar
9.Adams-Chapman, I, Stoll, BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr 2002;14:157–164.Google Scholar
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;327:88–93.Google Scholar
11.Yu, VY. Neonatal sepsis and infection control policies in Australia. J Paediatr Child Health 1990;26:252–256.Google Scholar
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;22:137–143.CrossRefGoogle Scholar
13.Larson, EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–269.CrossRefGoogle ScholarPubMed
14.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
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;23:120–126.Google Scholar
16.Pittet, D. Promotion of hand hygiene: magic, hype, or scientific challenge? Infect Control Hosp Epidemiol 2002;23:118–119.CrossRefGoogle ScholarPubMed
17.Larson, E, Kretzer, EK. Compliance with handwashing and barrier precautions. J Hosp Infect 1995;30(suppl):88–106.CrossRefGoogle ScholarPubMed
18.Pittet, D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000;21:381–386.Google Scholar
19.Albert, RK, Condie, F. Hand-washing patterns in medical intensive-care units. N Engl J Med 1981;304:1465–1466.Google Scholar
20.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126–130.Google Scholar
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;11:191–193.Google Scholar