Improving visitors' hand hygiene compliance in a pediatric oncology unit.


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
07 2022
Historique:
received: 01 09 2021
revised: 15 11 2021
accepted: 16 11 2021
pubmed: 2 12 2021
medline: 24 6 2022
entrez: 1 12 2021
Statut: ppublish

Résumé

Hand hygiene (HH) is the single most important method to prevent infections. We aim at improving HH compliance by visitors to a pediatric oncology unit. A performance improvement project implemented several Plan-Do-Study-Act cycles in July-November 2018. At baseline, a wall-mounted alcohol-based hand sanitizer dispenser was available at the unit entrance. Cycle 1 (visual cue), cycle 2 (visual cue plus verbal symptom screen), and cycle 3 (visual cue, symptom screen, plus HH verbal instructions) were tested. Patient care associates (PCA) positioned at the entrance implemented the cycles and recorded data about visitor's estimated age, day and time of observations, and covert HH compliance monitoring. Participating PCAs were surveyed regarding process feasibility. Of 1230 (97%) analyzed observations; 204 (17%) were baseline, 293 (24%) in cycle 1, 374 (30%) in cycle 2, and 359 (29%) in cycle 3. The visitors' HH compliance significantly increased to 16.0%, 22.5%, and 48.5% in cycles 1, 2, and 3, respectively, from a baseline of 4.9% (P < .001). Visitors were more likely to perform HH when directly instructed (cycle 3) compared to baseline (adjusted OR = 19.77, 95% CI, 10.30-42.09, P < .001). Although the surveyed PCAs agreed the process is easy and fast, they reported few barriers. Direct verbal instructions for HH were the most effective in improving visitors' HH compliance.

Sections du résumé

BACKGROUND
Hand hygiene (HH) is the single most important method to prevent infections. We aim at improving HH compliance by visitors to a pediatric oncology unit.
METHODS
A performance improvement project implemented several Plan-Do-Study-Act cycles in July-November 2018. At baseline, a wall-mounted alcohol-based hand sanitizer dispenser was available at the unit entrance. Cycle 1 (visual cue), cycle 2 (visual cue plus verbal symptom screen), and cycle 3 (visual cue, symptom screen, plus HH verbal instructions) were tested. Patient care associates (PCA) positioned at the entrance implemented the cycles and recorded data about visitor's estimated age, day and time of observations, and covert HH compliance monitoring. Participating PCAs were surveyed regarding process feasibility.
RESULTS
Of 1230 (97%) analyzed observations; 204 (17%) were baseline, 293 (24%) in cycle 1, 374 (30%) in cycle 2, and 359 (29%) in cycle 3. The visitors' HH compliance significantly increased to 16.0%, 22.5%, and 48.5% in cycles 1, 2, and 3, respectively, from a baseline of 4.9% (P < .001). Visitors were more likely to perform HH when directly instructed (cycle 3) compared to baseline (adjusted OR = 19.77, 95% CI, 10.30-42.09, P < .001). Although the surveyed PCAs agreed the process is easy and fast, they reported few barriers.
CONCLUSIONS
Direct verbal instructions for HH were the most effective in improving visitors' HH compliance.

Identifiants

pubmed: 34848293
pii: S0196-6553(21)00762-8
doi: 10.1016/j.ajic.2021.11.018
pii:
doi:

Substances chimiques

Hand Sanitizers 0
Ethanol 3K9958V90M

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

724-728

Informations de copyright

Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Angie Owings (A)

Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN.

Lori Christion (L)

Department of Nursing, St. Jude Children's Research Hospital, Memphis, TN.

Craig Gilliam (C)

Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN.

Bethany Glover (B)

Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN.

Shalini Bhatia (S)

Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN.

Li Tang (L)

Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN.

Hana Hakim (H)

Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN. Electronic address: Hana.Hakim@stjude.org.

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