Improving healthcare worker hand hygiene adherence before patient contact: A before-and-after five-unit multimodal intervention in Tuscany

Sanjay Saint, A. Conti, A. Bartoloni, G. Virgili, F. Mannelli, S. Fumagalli, P. Di Martino, A. A. Conti, S. R. Kaufman, M. A M Rogers, G. F. Gensini

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Despite the importance of hand hygiene in reducing infection, healthcare worker compliance with hand hygiene recommendations remains low. In a previous study, we found a generally low level of compliance at baseline, with substantial differences between doctors and nurses and between hospital units. We describe here the results of our multimodal intervention intended to improve levels of healthcare worker hand hygiene. Methods: A 6-month, before-and-after, multimodal interventional study in five hospital units in Florence, Italy. We used direct observation to assess hand hygiene rates for doctors and nurses, focusing on hygiene before touching the patient. We explored reasons for unit variability via interviews of doctor and nurse leaders on the units. Results: Overall healthcare worker hand hygiene increased from 31.5% to 47.4% (p <0.001). Hand hygiene adherence among nurses increased from 33.7% to 47.9% (p <0.001); adherence among doctors increased from 27.5% to 46.6% (p <0.001). Improvement was statistically significant in three out of five units, and units differed in the magnitude of their improvement. Based on the interviews, variability appeared related to the "champion" on each unit, as well as the level of motivation each physician leader exhibited when the preintervention results were provided. Conclusions: Although overall healthcare worker adherence with hand hygiene procedures before patient contact substantially increased after the multimodal intervention, considerable variability - for both nurses and doctors and across the 5 units - was seen. Although adherence substantially increased, overall hand hygiene in these units could still be greatly improved.

Original languageEnglish
Pages (from-to)429-433
Number of pages5
JournalQuality and Safety in Health Care
Volume18
Issue number6
DOIs
Publication statusPublished - Dec 2009

Fingerprint

Hand Hygiene
Patient Compliance
Delivery of Health Care
Nurses
Hospital Units
Interviews
Hygiene
Italy
Motivation
Observation
Physicians

ASJC Scopus subject areas

  • Health Policy

Cite this

Improving healthcare worker hand hygiene adherence before patient contact : A before-and-after five-unit multimodal intervention in Tuscany. / Saint, Sanjay; Conti, A.; Bartoloni, A.; Virgili, G.; Mannelli, F.; Fumagalli, S.; Di Martino, P.; Conti, A. A.; Kaufman, S. R.; Rogers, M. A M; Gensini, G. F.

In: Quality and Safety in Health Care, Vol. 18, No. 6, 12.2009, p. 429-433.

Research output: Contribution to journalArticle

Saint, S, Conti, A, Bartoloni, A, Virgili, G, Mannelli, F, Fumagalli, S, Di Martino, P, Conti, AA, Kaufman, SR, Rogers, MAM & Gensini, GF 2009, 'Improving healthcare worker hand hygiene adherence before patient contact: A before-and-after five-unit multimodal intervention in Tuscany', Quality and Safety in Health Care, vol. 18, no. 6, pp. 429-433. https://doi.org/10.1136/qshc.2009.032771
Saint, Sanjay ; Conti, A. ; Bartoloni, A. ; Virgili, G. ; Mannelli, F. ; Fumagalli, S. ; Di Martino, P. ; Conti, A. A. ; Kaufman, S. R. ; Rogers, M. A M ; Gensini, G. F. / Improving healthcare worker hand hygiene adherence before patient contact : A before-and-after five-unit multimodal intervention in Tuscany. In: Quality and Safety in Health Care. 2009 ; Vol. 18, No. 6. pp. 429-433.
@article{91b6067b435946b598da80e8643e12e7,
title = "Improving healthcare worker hand hygiene adherence before patient contact: A before-and-after five-unit multimodal intervention in Tuscany",
abstract = "Background: Despite the importance of hand hygiene in reducing infection, healthcare worker compliance with hand hygiene recommendations remains low. In a previous study, we found a generally low level of compliance at baseline, with substantial differences between doctors and nurses and between hospital units. We describe here the results of our multimodal intervention intended to improve levels of healthcare worker hand hygiene. Methods: A 6-month, before-and-after, multimodal interventional study in five hospital units in Florence, Italy. We used direct observation to assess hand hygiene rates for doctors and nurses, focusing on hygiene before touching the patient. We explored reasons for unit variability via interviews of doctor and nurse leaders on the units. Results: Overall healthcare worker hand hygiene increased from 31.5{\%} to 47.4{\%} (p <0.001). Hand hygiene adherence among nurses increased from 33.7{\%} to 47.9{\%} (p <0.001); adherence among doctors increased from 27.5{\%} to 46.6{\%} (p <0.001). Improvement was statistically significant in three out of five units, and units differed in the magnitude of their improvement. Based on the interviews, variability appeared related to the {"}champion{"} on each unit, as well as the level of motivation each physician leader exhibited when the preintervention results were provided. Conclusions: Although overall healthcare worker adherence with hand hygiene procedures before patient contact substantially increased after the multimodal intervention, considerable variability - for both nurses and doctors and across the 5 units - was seen. Although adherence substantially increased, overall hand hygiene in these units could still be greatly improved.",
author = "Sanjay Saint and A. Conti and A. Bartoloni and G. Virgili and F. Mannelli and S. Fumagalli and {Di Martino}, P. and Conti, {A. A.} and Kaufman, {S. R.} and Rogers, {M. A M} and Gensini, {G. F.}",
year = "2009",
month = "12",
doi = "10.1136/qshc.2009.032771",
language = "English",
volume = "18",
pages = "429--433",
journal = "Quality and Safety in Health Care",
issn = "1475-3898",
publisher = "BMJ Publishing Group",
number = "6",

}

TY - JOUR

T1 - Improving healthcare worker hand hygiene adherence before patient contact

T2 - A before-and-after five-unit multimodal intervention in Tuscany

AU - Saint, Sanjay

AU - Conti, A.

AU - Bartoloni, A.

AU - Virgili, G.

AU - Mannelli, F.

AU - Fumagalli, S.

AU - Di Martino, P.

AU - Conti, A. A.

AU - Kaufman, S. R.

AU - Rogers, M. A M

AU - Gensini, G. F.

PY - 2009/12

Y1 - 2009/12

N2 - Background: Despite the importance of hand hygiene in reducing infection, healthcare worker compliance with hand hygiene recommendations remains low. In a previous study, we found a generally low level of compliance at baseline, with substantial differences between doctors and nurses and between hospital units. We describe here the results of our multimodal intervention intended to improve levels of healthcare worker hand hygiene. Methods: A 6-month, before-and-after, multimodal interventional study in five hospital units in Florence, Italy. We used direct observation to assess hand hygiene rates for doctors and nurses, focusing on hygiene before touching the patient. We explored reasons for unit variability via interviews of doctor and nurse leaders on the units. Results: Overall healthcare worker hand hygiene increased from 31.5% to 47.4% (p <0.001). Hand hygiene adherence among nurses increased from 33.7% to 47.9% (p <0.001); adherence among doctors increased from 27.5% to 46.6% (p <0.001). Improvement was statistically significant in three out of five units, and units differed in the magnitude of their improvement. Based on the interviews, variability appeared related to the "champion" on each unit, as well as the level of motivation each physician leader exhibited when the preintervention results were provided. Conclusions: Although overall healthcare worker adherence with hand hygiene procedures before patient contact substantially increased after the multimodal intervention, considerable variability - for both nurses and doctors and across the 5 units - was seen. Although adherence substantially increased, overall hand hygiene in these units could still be greatly improved.

AB - Background: Despite the importance of hand hygiene in reducing infection, healthcare worker compliance with hand hygiene recommendations remains low. In a previous study, we found a generally low level of compliance at baseline, with substantial differences between doctors and nurses and between hospital units. We describe here the results of our multimodal intervention intended to improve levels of healthcare worker hand hygiene. Methods: A 6-month, before-and-after, multimodal interventional study in five hospital units in Florence, Italy. We used direct observation to assess hand hygiene rates for doctors and nurses, focusing on hygiene before touching the patient. We explored reasons for unit variability via interviews of doctor and nurse leaders on the units. Results: Overall healthcare worker hand hygiene increased from 31.5% to 47.4% (p <0.001). Hand hygiene adherence among nurses increased from 33.7% to 47.9% (p <0.001); adherence among doctors increased from 27.5% to 46.6% (p <0.001). Improvement was statistically significant in three out of five units, and units differed in the magnitude of their improvement. Based on the interviews, variability appeared related to the "champion" on each unit, as well as the level of motivation each physician leader exhibited when the preintervention results were provided. Conclusions: Although overall healthcare worker adherence with hand hygiene procedures before patient contact substantially increased after the multimodal intervention, considerable variability - for both nurses and doctors and across the 5 units - was seen. Although adherence substantially increased, overall hand hygiene in these units could still be greatly improved.

UR - http://www.scopus.com/inward/record.url?scp=73349120585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73349120585&partnerID=8YFLogxK

U2 - 10.1136/qshc.2009.032771

DO - 10.1136/qshc.2009.032771

M3 - Article

C2 - 19955452

AN - SCOPUS:73349120585

VL - 18

SP - 429

EP - 433

JO - Quality and Safety in Health Care

JF - Quality and Safety in Health Care

SN - 1475-3898

IS - 6

ER -