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. 2020 May 27;9(1):75.
doi: 10.1186/s13756-020-00732-7.

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

Yumi Suzuki  1   2 , Motoko Morino  3   4 , Ichizo Morita  5 , Shigenori Yamamoto  6
Affiliations

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

Yumi Suzuki et al. Antimicrob Resist Infect Control. .

Abstract

Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score.

Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson's correlation coefficients.

Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).

Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

Keywords: Alcohol-based hand rub; Compliance; Hand hygiene; Infection prevention; Multimodal initiative; World Health Organization.

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Conflict of interest statement

All listed authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Trends change in ABHR consumption before and after the implementation of the HH initiative. ABHR alcohol-based hand rub, HH hand hygiene, PD patient day
Fig. 2
Fig. 2
Relationship between annual ABHR consumption and HHSAF score. ABHR alcohol-based hand rub, HHSAF Hand Hygiene Self-Assessment Framework, PD patient day
See this image and copyright information in PMC

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