TY - JOUR
T1 - Increased hand hygiene compliance in nursing homes after a multimodal intervention
T2 - A cluster randomized controlled trial (HANDSOME)
AU - Teesing, Gwen R.
AU - Erasmus, Vicki
AU - Nieboer, Daan
AU - Petrignani, Mariska
AU - Koopmans, Marion P. G.
AU - Vos, Margreet C.
AU - Verduijn-Leenman, Annette
AU - Schols, Jos M. G. A.
AU - Richardus, Jan H.
AU - Voeten, Helene A. C. M.
N1 - Funding Information:
This study was funded by the Netherlands Organization for Health Research and Development (ZonMw, grant no. 522002010).
Publisher Copyright:
© 2020 Cambridge University Press. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - 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, andAfter 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.
AB - 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, andAfter 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.
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U2 - 10.1017/ice.2020.319
DO - 10.1017/ice.2020.319
M3 - Article
C2 - 32748765
SN - 0899-823X
VL - 41
SP - 1169
EP - 1177
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 10
M1 - PII S0899823X20003190
ER -