Alcohol-Based Hand Rub Consumption and World Health Organization Hand Hygiene Self-Assessment Framework: A Comparison Between the 2 Surveillances in a 4-Year Region-Wide Experience.
Journal
Journal of patient safety
ISSN: 1549-8425
Titre abrégé: J Patient Saf
Pays: United States
ID NLM: 101233393
Informations de publication
Date de publication:
01 Apr 2022
01 Apr 2022
Historique:
pubmed:
15
9
2021
medline:
3
5
2022
entrez:
14
9
2021
Statut:
ppublish
Résumé
Hand hygiene is essential for infection prevention. In Piedmont (Northwest Italy), hand hygiene is routinely monitored through 2 surveillance systems, the World Health Organization Hand Hygiene Self-Assessment Framework (HHSAF) and alcohol-based hand rub (ABHR) consumption. This study was aimed at (1) comparing the results of these surveillances, investigating the consistence of the 2 systems and (2) inquiring whether organizational differences among healthcare facilities significantly affected hand hygiene performances. A retrospective analysis was performed on data collected annually from 2015 to 2018 for both surveillances from 40 hospitals of the region: HHSAF score (500 points maximum) and ABHR consumption in milliliters per patient-day (mL/PD) were considered. Logistic regression models were built to evaluate possible correlations between these variables, and observations were clustered considering both variables to identify whether groups with significant differences could be discerned. A tree-structured partitioning model was used to confirm the obtained results. A positive correlation was observed between HHSAF score and odds of belonging to the high ABHR consumption group, particularly for cutoffs set to 19 to 23 mL/PD (P = 0.033 for 23 mL/PD). Two ABHR consumption peaks were identified at approximately 10 and 22 mL/PD, corresponding to median HHSAF scores of 353.75 and 375 points, respectively. The group with better performances was mainly composed of hub hospitals (with single-hospital management). The 2 surveillance systems are consistent, and the HHSAF score could work as a reasonable predictor of hand hygiene compliance in healthcare settings. Different management characteristics are crucial in creating a more/less favorable environment for hand hygiene compliance and infection prevention.
Identifiants
pubmed: 34520440
doi: 10.1097/PTS.0000000000000908
pii: 01209203-202204000-00024
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e658-e665Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors disclose no conflict of interest.
Références
Zarb P, Coignard B, Griskeviciene J, et al. The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Euro Surveill . 2012;17:20316.
Suetens C, Latour K, Kärki T, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill . 2018;23:1800516.
Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med . 2014;370:1198–1208.
Rutledge-Taylor K, Matlow A, Gravel D, et al. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control . 2012;40:491–496.
Stone SP. Hand hygiene—the case for evidence-based education. J R Soc Med . 2001;94:278–281.
Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet . 2003;362:1225–1230.
Chen YC, Sheng WH, Wang JT, et al. Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections. PLoS One . 2011;6:e27163.
Rosenthal VD, Guzman S, Safdar N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. Am J Infect Control . 2005;33:392–397.
Allegranzi B, Stewardson AJ, Pittet D. Compliance with hand hygiene best practices. In: Pittet D, Boyce JM, Allegranzi B, eds. Hand Hygiene: A Handbook for Medical Professionals . 1st ed. Hoboken, NJ: John Wiley & Sons; 2017:76–84.
Teare L, Cookson B, Stone S. Hand hygiene. BMJ . 2001;323:412–413.
Gould D, Moralejo D, Drey N, et al. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev . 2017;CD005186.
Mertz D, Dafoe N, Walter SD, et al. Effect of a multifaceted intervention on adherence to hand hygiene among healthcare workers: a cluster-randomized trial. Infect Control Hosp Epidemiol . 2010;31:1170–1176.
Moghnieh R, Soboh R, Abdallah D, et al. Health care workers’ compliance to the my 5 moments for hand hygiene: comparison of 2 interventional methods. Am J Infect Control . 2017;45:89–91.
Midturi JK, Narasimhan A, Barnett T, et al. A successful multifaceted strategy to improve hand hygiene compliance rates. Am J Infect Control . 2015;43:533–536.
Dubbert PM, Dolce J, Richter W, et al. Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol . 1990;11:191–193.
World Health Organization. Hand hygiene self-assessment framework 2010. October 1, 2010. Available at: https://www.who.int/gpsc/country_work/hhsa_framework_October_2010.pdf?ua=1 . Accessed December 1, 2020.
Stewardson AJ, Allegranzi B, Perneger TV, et al. Testing the WHO Hand Hygiene Self-Assessment Framework for usability and reliability. J Hosp Infect . 2013;83:30–35.
Tartari E, Muthukumaran P, Peters A, et al. Monitoring your institution: the WHO Hand Hygiene Self-Assessment Framework—is it worth it? Clin Microbiol Infect . 2019;25:925–928.
Regional Health Department of Piedmont (Regione Piemonte). Indicatori per Sorveglianza e Controllo delle Infezioni Correlate all’Assistenza (ICA) Anno 2015. December 2019. Available at: https://sorveglianzedssppunito.it/wp-content/uploads/2019/12/indicatori-2015.pdf . Accessed November 21, 2020.
Regional Health Department of Piedmont (Regione Piemonte). Indicatori per Sorveglianza e Controllo delle Infezioni Correlate all’Assistenza (ICA) Anno 2016. December 2019. Available at: https://sorveglianzedssppunito.it/wp-content/uploads/2019/12/indicatori-2016.pdf . Accessed November 21, 2020.
Regional Health Department of Piedmont (Regione Piemonte). Indicatori per Sorveglianza e Controllo delle Infezioni Correlate all’Assistenza (ICA) Anno 2017. December 2019. Available at: https://sorveglianzedssppunito.it/wp-content/uploads/2019/12/indicatori-2017.pdf . Accessed November 21, 2020.
Regional Health Department of Piedmont (Regione Piemonte). Indicatori per Sorveglianza e Controllo delle Infezioni Correlate all’Assistenza (ICA) Anno 2018. December 2019. Available at: https://sorveglianzedssppunito.it/wp-content/uploads/2019/12/indicatori-2018.pdf . Accessed November 21, 2020.
Ehrenkranz NJ, Alfonso BC. Failure of Bland Soap Handwash to Prevent Hand Transfer of Patient Bacteria to Urethral Catheters. Infect Control Hosp Epidemiol . 1991;12:654–662.
Picheansathian W. A systematic review on the effectiveness of alcohol-based solutions for hand hygiene. Int J Nurs Pract . 2004;10:3–9.
World Health Organization. WHO Guidelines on Hand Hygiene in Health Care . Geneva: WHO Press; 2009.
Behnke M, Clausmeyer J, Reichardt C, et al. Alcohol-based hand rub consumption surveillance in German hospitals—latest results. Antimicrob Resist Infect Control . 2015;4(S1):P293.
Suzuki Y, Morino M, Morita I, et al. The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study. Antimicrob Resist Infect Control . 2020;9:75.
Rechel B, Maresso A, Sagan A, et al. Organization and financing of public health services in Europe: country reports. Eur Obs Heal Syst Policies . 2018;49:133.
Hu SP. Simple mean, weighted mean, or geometric mean? In: 2010 ISPA/SCEA Joint Annual Conference and Training Workshop . San Diego, CA: Tecolote Research Inc.; 2010:1–17.
Beggs CB, Shepherd SJ, Kerr KG. Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward. BMC Infect Dis . 2008;8:114.
Scrucca L, Fop M, Murphy TB, et al. mclust 5: clustering, classification and density estimation using Gaussian finite mixture models. R J . 2016;8:289–317.
Hothorn T, Hornik K, Zeileis A. Unbiased recursive partitioning: a conditional inference framework. J Comput Graph Stat . 2006;15:651–674.
Hothorn T, Seibold H, Zeileis A. partykit: a modular toolkit for recursive partytioning in R. J Mach Learn Res . 2015;16:3905–3909.
R: A Language and Environment for Statistical Computing [computer program]. Version 4.0.0 . R Core Team: Vienna; 2020.
Kratzel A, Todt D, V’kovski P, et al. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis . 2020;26:1592–1595.
Italian Ministry of Health. Piano Nazionale di Contrasto dell’Antimicrobico-Resistenza (PNCAR). November 2017. Available at: https://www.salute.gov.it/imgs/C_17_pubblicazioni_2660_allegato.pdf . Accessed May 20, 2021.
Bert F, Giacomelli S, Ceresetti D, et al. World Health Organization framework: multimodal hand hygiene strategy in Piedmont (Italy) health care facilities. J Patient Saf . 2019;15:317–321.
Behnke M, Gastmeier P, Geffers C, et al. Establishment of a national surveillance system for alcohol-based hand rub consumption and change in consumption over 4 years. Infect Control Hosp Epidemiol . 2012;33:618–620.
National Reference Center for Nosocomial Infection Surveillance at the Institute for Hygiene and Environmental Medicine, Charité – Universitätsmedizin Berlin. HAND-KISS: Surveillance of alcohol hand rub use. April 2012. Available at: https://www.nrz-hygiene.de/fileadmin/nrz/module/hand/HAND-KISS_protocol_S_F_april_2012.pdf . Accessed December 1, 2020.
Zahar JR, Masse V, Watier L, et al. Is hand-rub consumption correlated with hand hygiene and rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) acquired infections? J Hosp Infect . 2012;80:348–350.
Borg MA, Brincat A. Addressing the controversy of 100% hand hygiene compliance: can alcohol rub consumption data serve as a useful proxy validator? J Hosp Infect . 2018;100:218–219.
Boyce JM. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infect Control Hosp Epidemiol . 2011;32:1016–1028.
Cheng VC, Tai JW, Chan WM, et al. Sequential introduction of single room isolation and hand hygiene campaign in the control of methicillin-resistant Staphylococcus aureus in intensive care unit. BMC Infect Dis . 2010;10. doi:10.1186/1471-2334-10-263.
doi: 10.1186/1471-2334-10-263
Eckmanns T, Schwab F, Bessert J, et al. Hand rub consumption and hand hygiene compliance are not indicators of pathogen transmission in intensive care units. J Hosp Infect . 2006;63:406–411.
Eldridge NE, Woods SS, Bonello RS, et al. Using the six sigma process to implement the Centers for Disease Control and Prevention guideline for hand hygiene in 4 intensive care units. J Gen Intern Med . 2006;21(suppl 2):35–42.
Scheithauer S, Haefner H, Schwanz T, et al. Compliance with hand hygiene on surgical, medical, and neurologic intensive care units: direct observation versus calculated disinfectant usage. Am J Infect Control . 2009;37:835–841.
Direction de l’Hospitalisation et de l’Organisation des Soins (Ministère des Solidarités et de la Santé). Circulaire DHOS/E2/DGS/5C N° 2006-121 Du 13 Mars 2006 Relative Au Tableau de Bord Des Infections Nosocomiales et Portant Sur Les Modalités de Calcul et de Présentation de l’indicateur de Volume de Produits Hydro-Alcooliques Consommé Par Les Établissements. Paris, France:2006.
Grammatico-Guillon L, Thiolet J-M, Bernillon P, et al. Relationship between the prevalence of methicillin-resistant Staphylococcus aureus infection and indicators of nosocomial infection control measures a population-based study in French hospitals. Infect Control Hosp Epidemiol . 2009;30:861–869.
Larson EL, Early E, Cloonan P, et al. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med . 2000;26:14–22.
Scheithauer S, Lemmen SW. How can compliance with hand hygiene be improved in specialized areas of a university hospital? J Hosp Infect . 2013;83(S1):S17–S22.
Caris MG, Kamphuis PGA, Dekker M, et al. Patient safety culture and the ability to improve: a proof of concept study on hand hygiene. Infect Control Hosp Epidemiol . 2017;38:1277–1283.