Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME). (4th October 2020)

• Record Type: Journal Article
• Authors: Teesing, Gwen R.; Erasmus, Vicki; Nieboer, Daan; Petrignani, Mariska; Koopmans, Marion P.G; Vos, Margreet C.; Verduijn-Leenman, Annette; Schols, Jos M.G.A; Richardus, Jan H.; Voeten, Helene A.C.M
• Is Part Of: Infection control and hospital epidemiology. Volume 41:Number 10(2020)
• Page Start: 1169
• Page End: 1177
• Publication Date: 2020-10-04
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2020.319
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract: Objective: To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes. Design, setting, and participants: HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded. Intervention: Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty . Results: HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%). Conclusions: The HANDSOME intervention is successful in improving HHC in nursing homes.