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Arch Intern Med. 2002 May 13;162(9):1037-43.

Alcohol-based handrub improves compliance with hand hygiene in intensive care units.

Author information

1
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.

Abstract

BACKGROUND:

Nosocomial infection is a leading complication in intensive care units. Although hand hygiene is the single most efficient preventive measure, compliance with this simple action remains low.

OBJECTIVES:

To assess the effect of an intervention to promote hand hygiene and to investigate risk factors for noncompliance in intensive care units.

METHODS:

We performed 7 observational surveys and implemented a promotional campaign after baseline in medical, surgical, and pediatric intensive care units of a teaching hospital. Health care workers were observed during routine patient care. The intervention consisted of a hospitalwide promotional campaign, including observation and performance feedback, posters display, and distribution of individual bottles of alcohol-based handrub. The main outcome measure was compliance with hand hygiene through handwashing or handrubbing.

RESULTS:

We observed 2743 opportunities for hand hygiene distributed over 248 periods. Overall compliance increased from 38.4% to 54.5% during the study (P<.001). Although recourse to handwashing remained stable at around 30%, handrubbing increased from 5.4% at baseline to 21.7% at the last survey (P<.001). Compliance increased among nurses and nursing assistants, but remained stable among physicians. Handwashing compliance decreased, on average, by 4.7% for an increase of 10 opportunities for hand hygiene per hour of patient care (P<.001), whereas no such association existed for handrubbing.

CONCLUSIONS:

Our intervention induced a marked and sustained increase in compliance with hand hygiene. In intensive care units, less time-consuming handrubbing might replace standard handwashing and overcome the barrier of time constraints.

PMID:
11996615
[Indexed for MEDLINE]

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