Effect of gloved hand disinfection on hand hygiene before infection-prone procedures on a stem cell ward.
Bacteria
/ drug effects
Bacterial Infections
/ epidemiology
Catheter-Related Infections
/ prevention & control
Catheterization
/ adverse effects
Cross Infection
/ prevention & control
Drug Resistance, Multiple, Bacterial
Female
Guideline Adherence
Hand Disinfection
/ methods
Humans
Incidence
Infection Control
/ methods
Male
Stem Cell Transplantation
/ adverse effects
Compliance
Gloves
Hand hygiene
Healthcare-associated infection
Infection control
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
20
03
2019
revised:
09
06
2019
accepted:
11
06
2019
pubmed:
22
6
2019
medline:
27
2
2020
entrez:
22
6
2019
Statut:
ppublish
Résumé
Hand hygiene compliance even before infection-prone procedures (indication 2, 'before aseptic tasks', according to the World Health Organization (WHO)) remains disappointing. To improve hand hygiene compliance by implementing gloved hand disinfection as a resource-neutral process optimization strategy. We performed a three-phase intervention study on a stem cell transplant ward. After baseline evaluation of hand hygiene compliance (phase 1) gloved hand disinfection was allowed (phase 2) and restricted (phase 3) to evaluate and differentiate intervention derived from learning and time effects. The incidence of severe infections as well as of hospital-acquired multidrug-resistant bacteria was recorded by active surveillance. Hand hygiene compliance improved significantly from 50% to 76% (P < 0.001) when gloved hand disinfection was allowed. The biggest increase was for infection-prone procedures (WHO 2) from 31% to 65%; P < 0.001. Severe infections decreased by trend (from 6.0 to 2.5 per 1000 patient-days) whereas transmission of multidrug-resistant organisms was not affected. Gloved hand disinfection significantly improved compliance with the hand hygiene, especially in activities relevant to infections and infection prevention. Thus, this process optimization may be an additional, easy implementable, resource-neutral tool for a highly vulnerable patient cohort.
Sections du résumé
BACKGROUND
BACKGROUND
Hand hygiene compliance even before infection-prone procedures (indication 2, 'before aseptic tasks', according to the World Health Organization (WHO)) remains disappointing.
AIM
OBJECTIVE
To improve hand hygiene compliance by implementing gloved hand disinfection as a resource-neutral process optimization strategy.
METHODS
METHODS
We performed a three-phase intervention study on a stem cell transplant ward. After baseline evaluation of hand hygiene compliance (phase 1) gloved hand disinfection was allowed (phase 2) and restricted (phase 3) to evaluate and differentiate intervention derived from learning and time effects. The incidence of severe infections as well as of hospital-acquired multidrug-resistant bacteria was recorded by active surveillance.
FINDINGS
RESULTS
Hand hygiene compliance improved significantly from 50% to 76% (P < 0.001) when gloved hand disinfection was allowed. The biggest increase was for infection-prone procedures (WHO 2) from 31% to 65%; P < 0.001. Severe infections decreased by trend (from 6.0 to 2.5 per 1000 patient-days) whereas transmission of multidrug-resistant organisms was not affected.
CONCLUSION
CONCLUSIONS
Gloved hand disinfection significantly improved compliance with the hand hygiene, especially in activities relevant to infections and infection prevention. Thus, this process optimization may be an additional, easy implementable, resource-neutral tool for a highly vulnerable patient cohort.
Identifiants
pubmed: 31226271
pii: S0195-6701(19)30258-0
doi: 10.1016/j.jhin.2019.06.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
321-327Informations de copyright
Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.