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J Microbiol Immunol Infect. 2019 Apr;52(2):345-351. doi: 10.1016/j.jmii.2018.09.007. Epub 2018 Sep 28.

Implementation of a national quality improvement program to enhance hand hygiene in nursing homes in Taiwan.

Author information

1
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
2
Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan.
3
Department of Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Infection Control Center, Chi-Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
4
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
5
Center for Infection Control, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
6
Infection Control Center, MacKay Memorial Hospital, Taipei, Taiwan.
7
Department of Infection Control, Show Chwan Memorial Hospital, Changhua, Taiwan.
8
Center for Infection Control, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
9
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
10
Infection Control Center, Chi-Mei Medical Center, Tainan, Taiwan; Department of Nursing, College of Medicine and Life Sciene, Chung Hwa University of Medical Technology, Tainan, Taiwan. Electronic address: yuyu711chen@gmail.com.

Abstract

BACKGROUND/PURPOSE:

This study investigated the cause of hand hygiene deficit, and further implemented a quality improvement program using WHO's hand-hygiene strategy to enhance the compliance of hand hygiene in the nursing home in Taiwan.

METHODS:

This prospective study was conducted in eleven nursing homes in Taiwan from January 2015 to December 2016. After intervention, we monitor the compliance, and accuracy of hand hygiene. In addition, we also calculated the number of episodes of infection per 1000 resident-days in each nursing home in the intervention period (July-December 2015) and post-intervention period (January-October 2016).

RESULTS:

Overall, the consumption of alcohol-based handrubs increased from 10.1 ml per resident-day in intervention period to 12.2 ml per resident-day in post intervention period. The compliance of hand hygiene increased from 74% in intervention period to 79% in post-intervention period and the rate of correct hand hygiene increased from 81% in intervention period to 87% in post-intervention period. Most importantly, the infection density decreased from 2.39 per 1000 resident-day in intervention period to 1.89 per 1000 resident-day.

CONCLUSIONS:

A national quality-improvement program using WHO's hand-hygiene strategy to enhance hand hygiene and reduce healthcare associated infection is effective in nursing homes in Taiwan.

KEYWORDS:

Hand hygiene; Nursing homes; Quality improvement program; Taiwan

PMID:
30316727
DOI:
10.1016/j.jmii.2018.09.007
[Indexed for MEDLINE]
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