Table 8After vs. before implementation of a hand hygiene guideline - Clinical summary of findings

OutcomeAfterBeforeRelative riskAbsolute effectQuality
Implementation of APIC guideline
Hand decontamination compliance - overall358/1639
(21.8%)
155/1932
(8%)
RR 2.72
(2.28 to 3.25)
138 more per 1000
(103 more to 181 more)
VERY LOW
Nosocomial infections – per 1000 bed daysN/RN/RRR 0.59
(0.47 to 0.75)
N/RVERY LOW
Implementation of WHO 5 moments of hand hygiene
Hand decontamination compliance - overall358/1639
(21.8%)
155/1932
(8%)
RR 2.72
(2.28 to 3.25)
138 more per 1000
(103 more to 181 more)
VERY LOW
Hand decontamination compliance – before patient contact91/439
(20.7%)
23/503
(4.6%)
RR 4.53
(2.92 to 7.03)
161 more per 1000
(88 more to 276 more)
VERY LOW
Hand decontamination compliance – before aseptic task34/230
(14.8%)
11/425
(2.6%)
RR 5.71
(2.95 to 11.06)
122 more per 1000
(50 more to 260 more)
VERY LOW
Hand decontamination compliance – After body fluid exposure risk94/229
(41%)
34/215
(15.8%)
RR 2.6
(1.84 to 3.67)
253 more per 1000
(133 more to 422 more)
VERY LOW
Hand decontamination compliance – After patient contact201/505
(39.8%)
91/559
(16.3%)
RR 2.44
(1.97 to 3.04)
234 more per 1000
(158 more to 332 more)
VERY LOW
Hand decontamination compliance – After contact with patient surroundings15/410
(3.7%)
15/457
(3.3%)
RR 1.11
(0.55 to 2.25)
4 more per 1000
(15 fewer to 41 more)
VERY LOW
Healthcare-associated infections – Overall22/144
(15.3%)
25/134
(18.7%)
RR 0.82
(0.49 to 1.38)
34 fewer per 1000
(95 fewer to 71 more)
VERY LOW
Healthcare-associated infections – Urinary tract infections10/144
(6.9%)
8/134 (6%)RR 1.16
(0.47 to 2.86)
10 more per 1000
(32 fewer to 111 more)
VERY LOW
Healthcare-associated infections – Primary blood stream infections1/144
(0.7%)
3/134
(2.2%)
RR 0.31
(0.03 to 2.95)
15 fewer per 1000
(22 fewer to 44 more)
VERY LOW
Implementation of CDC 2002 guideline
Hand decontamination compliance – Before patient care696/1698
(41%)
761/2537
(30%)
RR 1.37
(1.26 to 1.48)
111 more per 1000
(78 more to 144 more)
VERY LOW
Hand decontamination compliance – After patient care707/955
(74%)
784/1104
(71%)
RR 1.04
(0.99 to 1.1)
28 more per 1000
(7 fewer to 71 more)
VERY LOW
Catheter associated urinary tract infection524/17315 4
(0.3%)
498/17162 5
(0.3%)
RR 1.04
(0.92 to 1.18)
0 more per 1000
(0 fewer to 1 more)
VERY LOW
Central line associated blood stream infection771/16195 4
(0.5%)
848/15300 3
(0.6%)
RR 0.86
(0.78 to 0.95)
1 fewer per 1000
(0 fewer to 1 fewer)
VERY LOW

From: 6, Standard principles for hand decontamination

Cover of Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care
Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2.
NICE Clinical Guidelines, No. 139.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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