OBJECTIVE: To determine the effectiveness of World Health Organization (WHO) multimodal strategy in promoting hand hygiene (HH) among healthcare workers (HCWs) in long-term care facilities (LTCFs). DESIGN: Cluster-randomized controlled trial. SETTING:Eighteen homes for the elderly in Hong Kong were randomly allocated to 2 intervention arms and a control arm. Direct observation of HH practice was conducted by trained nurses. Either handrubbing with alcohol-based handrub (ABHR) or handwashing with liquid soap and water was counted as a compliant action. Disease notification data during 2007-2010 were used to calculate incidence rate ratio (IRR). PARTICIPANTS: Managers and HCWs of the participating homes. INTERVENTIONS: The WHO multimodal strategy was employed. All intervention homes were supplied with ABHR (WHO formulation I), ABHR racks, pull reels, HH posters and reminders, a health talk, video clips, training materials, and performance feedback. The only difference was that intervention arms 1 and 2 were provided with slightly powdered and powderless gloves, respectively. RESULTS: A total of 11,669 HH opportunities were observed. HH compliance increased from 27.0% to 60.6% and from 22.2% to 48.6% in intervention arms 1 and 2, respectively. Both intervention arms showed increased HH compliance after intervention compared to controls, at 21.6% compliance (both [Formula: see text]). Provision of slightly powdered versus powderless gloves did not have any significant impact on ABHR usage. Respiratory outbreaks (IRR, 0.12; 95% confidence interval [CI], 0.01-0.93; [Formula: see text]) and methicillin-resistant Staphylococcus aureus infections requiring hospital admission (IRR, 0.61; 95% CI, 0.38-0.97; [Formula: see text]) were reduced after intervention. CONCLUSIONS: A promotion program applying the WHO multimodal strategy was effective in improving HH among HCWs in LTCFs.
RCT Entities:
OBJECTIVE: To determine the effectiveness of World Health Organization (WHO) multimodal strategy in promoting hand hygiene (HH) among healthcare workers (HCWs) in long-term care facilities (LTCFs). DESIGN: Cluster-randomized controlled trial. SETTING: Eighteen homes for the elderly in Hong Kong were randomly allocated to 2 intervention arms and a control arm. Direct observation of HH practice was conducted by trained nurses. Either handrubbing with alcohol-based handrub (ABHR) or handwashing with liquid soap and water was counted as a compliant action. Disease notification data during 2007-2010 were used to calculate incidence rate ratio (IRR). PARTICIPANTS: Managers and HCWs of the participating homes. INTERVENTIONS: The WHO multimodal strategy was employed. All intervention homes were supplied with ABHR (WHO formulation I), ABHR racks, pull reels, HH posters and reminders, a health talk, video clips, training materials, and performance feedback. The only difference was that intervention arms 1 and 2 were provided with slightly powdered and powderless gloves, respectively. RESULTS: A total of 11,669 HH opportunities were observed. HH compliance increased from 27.0% to 60.6% and from 22.2% to 48.6% in intervention arms 1 and 2, respectively. Both intervention arms showed increased HH compliance after intervention compared to controls, at 21.6% compliance (both [Formula: see text]). Provision of slightly powdered versus powderless gloves did not have any significant impact on ABHR usage. Respiratory outbreaks (IRR, 0.12; 95% confidence interval [CI], 0.01-0.93; [Formula: see text]) and methicillin-resistant Staphylococcus aureus infections requiring hospital admission (IRR, 0.61; 95% CI, 0.38-0.97; [Formula: see text]) were reduced after intervention. CONCLUSIONS: A promotion program applying the WHO multimodal strategy was effective in improving HH among HCWs in LTCFs.
Authors: Jackson S Musuuza; Anna Barker; Caitlyn Ngam; Lia Vellardita; Nasia Safdar Journal: Infect Control Hosp Epidemiol Date: 2016-02-10 Impact factor: 3.254
Authors: Vincent C C Cheng; Hong Chen; Shuk-Ching Wong; Jonathan H K Chen; Wing-Chun Ng; Simon Y C So; Tuen-Ching Chan; Sally C Y Wong; Pak-Leung Ho; Lona Mody; Felix H W Chan; Andrew T Y Wong; Kwok-Yung Yuen Journal: Infect Control Hosp Epidemiol Date: 2018-02-27 Impact factor: 3.254