Tomoko Sakihama1, Hitoshi Honda2, Sanjay Saint3,4, Karen E Fowler3, Toru Kamiya5, Yumiko Sato6, Ritsuko Iuchi7, Yasuharu Tokuda8. 1. Department of Nursing, International University of Health and Welfare Graduate School, Minato-ku, Tokyo, Japan. 2. Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan. 3. VA Ann Arbor Healthcare System, Ann Arbor, Michigan. 4. University of Michigan Medical School, Ann Arbor, Michigan. 5. Division of General Internal Medicine & Infectious Diseases, Rakuwakai Otowa Hospital, Yamashina, Kyoto, Japan. 6. Division of Infection Control, Teine Keijinkai Medical Center, Sapporo, Hokkaido, Japan. 7. Division of Infection Control, Rakuwakai Otowa Hospital, Yamashina, Kyoto, Japan. 8. Japan Community Healthcare Organization, Minato-ku, Tokyo, Japan.
Abstract
BACKGROUND: Though hand hygiene is an important method of preventing healthcare-associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%-25%). OBJECTIVE: Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. SETTING: A total of 3 to 4 inpatient wards in 3 Japanese hospitals. DESIGN: Pre-post intervention study. INTERVENTION: The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. MEASUREMENT: We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre-intervention adherence rates. RESULTS: We observed 2982 postintervention provider-patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre- to 33% postintervention; P < 0.001), but postintervention adherence rates varied considerably: hospital A + 29%, B + 5%, C + 8%. Hospital A won the contest with 40% adherence after the intervention. CONCLUSIONS: Using a novel contest coupled with a multimodal intervention successfully improved hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary.
BACKGROUND: Though hand hygiene is an important method of preventing healthcare-associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%-25%). OBJECTIVE: Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. SETTING: A total of 3 to 4 inpatient wards in 3 Japanese hospitals. DESIGN: Pre-post intervention study. INTERVENTION: The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. MEASUREMENT: We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre-intervention adherence rates. RESULTS: We observed 2982 postintervention provider-patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre- to 33% postintervention; P < 0.001), but postintervention adherence rates varied considerably: hospital A + 29%, B + 5%, C + 8%. Hospital A won the contest with 40% adherence after the intervention. CONCLUSIONS: Using a novel contest coupled with a multimodal intervention successfully improved hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary.