A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption

doi:10.1016/j.infpip.2022.100256

. 2022 Oct 20;4(4):100256.

doi: 10.1016/j.infpip.2022.100256. eCollection 2022 Dec.

A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption

Retsu Fujita¹, James W Arbogast², Rika Yoshida³, Satoshi Hori⁴

Affiliations

¹ Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.
² GOJO Industries Inc. Akron, OH, USA.
³ Division of Infection Prevention and Control, Postgraduate School, Tokyo Healthcare University, Tokyo, Japan.
⁴ Department of Infection Control Science, Juntendo University School of Medicine, Tokyo, Japan.

PMID: 36387608
PMCID: PMC9646915
DOI: 10.1016/j.infpip.2022.100256

A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption

Retsu Fujita et al. Infect Prev Pract. 2022.

. 2022 Oct 20;4(4):100256.

doi: 10.1016/j.infpip.2022.100256. eCollection 2022 Dec.

Authors

Retsu Fujita¹, James W Arbogast², Rika Yoshida³, Satoshi Hori⁴

Affiliations

¹ Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.
² GOJO Industries Inc. Akron, OH, USA.
³ Division of Infection Prevention and Control, Postgraduate School, Tokyo Healthcare University, Tokyo, Japan.
⁴ Department of Infection Control Science, Juntendo University School of Medicine, Tokyo, Japan.

PMID: 36387608
PMCID: PMC9646915
DOI: 10.1016/j.infpip.2022.100256

Abstract

Introduction: The World Health Organization recommends monitoring alcohol-based handrub (ABHR) consumption and direct observation of hand hygiene practices to ensure compliance. In Japan monitoring of ABHR consumption is widely performed. However, direct observation is not common, particularly in small facilities and non-acute-care facilities. Hence, the current study aimed to evaluate the longitudinal effects of direct observation of hand hygiene practices and monitoring of ABHR consumption with provision of feedback to healthcare personnel on ABHR consumption and hand hygiene compliance.

Methods: We conducted a 4-year prospective intervention study. Monitoring of ABHR consumption and direct observation of hand hygiene practices with monthly feedback to healthcare personnel was implemented in 17 facilities. These consisted of 11 acute-care facilities of varying sizes and six non-acute-care facilities. A generalized linear mixed model analysis was performed to assess factors associated with ABHR consumption.

Results: All facilities implemented ABHR consumption monitoring within one month of starting the study. However, the mean time required to implement direct observation of hand hygiene practices was 24.7 (±19.1) months. The ABHR consumption increased significantly (P<0.0001) in all medical facilities after implementing the direct observation. Multivariable regression analysis showed the hospital ward type, duration of ABHR consumption monitoring, and duration of direct observation of hand hygiene practices were independently associated with ABHR consumption.

Conclusions: Direct observation of hand hygiene practices with feedback should be implemented more widely in combination with ABHR consumption monitoring to help increase hand hygiene compliance.

Keywords: ABHR, alcohol-based hand rub; Acute-care hospital; Alcohol-based hand rub; Compliance; Hand hygiene; Intervention study; Monitoring; Non-acute-care facility; WHO, World Health Organization.

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Figures

**Figure 1**
Annual changes in the volume of alcohol-based handrub (ABHR) consumption averaged by healthcare facility type.

**Figure 2**
The change in Alcohol-based handrub (ABHR) consumption before to after implementing direct observation for each individual healthcare facility.

See this image and copyright information in PMC

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References

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1. Lambe K.A., Lydon S., Madden C., Vellinga A., Hehir A., Walsh M., et al. Hand hygiene compliance in the ICU: A systematic review. Crit Care Med. 2019;47:1251–1257. doi: 10.1097/CCM.0000000000003868. - DOI - PubMed
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1. Sakihama T., Honda H., Saint S., Fowler K.E., Shimizu T., Kamiya T., et al. Hand hygiene adherence among health care workers at Japanese hospitals: A multicenter observational study in Japan. J Patient Saf. 2016;12:11–17. doi: 10.1097/PTS.0000000000000108. - DOI - PubMed
1. Kato H., Takeda R., Ideno Y., Suzuki T., Sano K., Nakamura K. Physicians' compliance for hand hygiene in medical outpatient clinics: Automated hand-hygiene monitoring with touch sensor and wireless internet. Am J Infect Control. 2021;49:50–54. doi: 10.1016/j.ajic.2020.05.037. - DOI - PubMed

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[1] Gould D.J., Moralejo D., Drey N., Chudleigh J.H., Taljaard M. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev. 2017;9:CD005186. doi: 10.1002/14651858.CD005186.pub4. - DOI - PMC - PubMed

[2] Gould D.J., Moralejo D., Drey N., Chudleigh J.H., Taljaard M. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev. 2017;9:CD005186. doi: 10.1002/14651858.CD005186.pub4. - DOI - PMC - PubMed

[3] Lambe K.A., Lydon S., Madden C., Vellinga A., Hehir A., Walsh M., et al. Hand hygiene compliance in the ICU: A systematic review. Crit Care Med. 2019;47:1251–1257. doi: 10.1097/CCM.0000000000003868. - DOI - PubMed

[4] Lambe K.A., Lydon S., Madden C., Vellinga A., Hehir A., Walsh M., et al. Hand hygiene compliance in the ICU: A systematic review. Crit Care Med. 2019;47:1251–1257. doi: 10.1097/CCM.0000000000003868. - DOI - PubMed

[5] Laskar A.M., Deepashree R., Bhat P., Pottakkat B., Narayan S., Sastry A.S., et al. A multimodal intervention to improve hand hygiene compliance in a tertiary care center. Am J Infect Control. 2018;46:775–780. doi: 10.1016/j.ajic.2017.12.017. - DOI - PubMed

[6] Laskar A.M., Deepashree R., Bhat P., Pottakkat B., Narayan S., Sastry A.S., et al. A multimodal intervention to improve hand hygiene compliance in a tertiary care center. Am J Infect Control. 2018;46:775–780. doi: 10.1016/j.ajic.2017.12.017. - DOI - PubMed

[7] Sakihama T., Honda H., Saint S., Fowler K.E., Shimizu T., Kamiya T., et al. Hand hygiene adherence among health care workers at Japanese hospitals: A multicenter observational study in Japan. J Patient Saf. 2016;12:11–17. doi: 10.1097/PTS.0000000000000108. - DOI - PubMed

[8] Sakihama T., Honda H., Saint S., Fowler K.E., Shimizu T., Kamiya T., et al. Hand hygiene adherence among health care workers at Japanese hospitals: A multicenter observational study in Japan. J Patient Saf. 2016;12:11–17. doi: 10.1097/PTS.0000000000000108. - DOI - PubMed

[9] Kato H., Takeda R., Ideno Y., Suzuki T., Sano K., Nakamura K. Physicians' compliance for hand hygiene in medical outpatient clinics: Automated hand-hygiene monitoring with touch sensor and wireless internet. Am J Infect Control. 2021;49:50–54. doi: 10.1016/j.ajic.2020.05.037. - DOI - PubMed

[10] Kato H., Takeda R., Ideno Y., Suzuki T., Sano K., Nakamura K. Physicians' compliance for hand hygiene in medical outpatient clinics: Automated hand-hygiene monitoring with touch sensor and wireless internet. Am J Infect Control. 2021;49:50–54. doi: 10.1016/j.ajic.2020.05.037. - DOI - PubMed

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A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption

Affiliations

A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption

Authors

Affiliations

Abstract

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References

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