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. 2023 May;10(5):3367-3377.
doi: 10.1002/nop2.1591. Epub 2023 Jan 3.

Action research on promoting hand hygiene practices in an intensive care unit

Kirsi Terho  1   2 , Esa Rintala  2 , Janne Engblom  3 , Sanna Salanterä  1   4
Affiliations

Action research on promoting hand hygiene practices in an intensive care unit

Kirsi Terho et al. Nurs Open. 2023 May.

Abstract

Aim: Evaluate the intensive care acquired infections incidence and the change over time in infection practices in one intensive care unit.

Design: We used an action research approach with cyclical activities.

Methods: Our study included two cycles with hand hygiene observation based on the WHO's five-moments observation tool, observing hand hygiene practices, analysing the observations, and giving feedback on observations, intensive care acquired infection rates, and alcohol-based hand rub consumption. The Revised Standards for Quality Improvement Reporting Excellence is the basis for this research report describing research aimed at improving patient safety and quality of care.

Results: During the study, annual alcohol-based hand rub consumption increased by 6.7 litres per 1000 patient days and observed hand hygiene compliance improved. In the first cycle of the study, there was a decrease in critical care acquired infection rates, but the improvement was not sustainable.

Keywords: action research; consumption; hand hygiene; hand rub; healthcare-associated infection; intensive care.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The cycle on the action research. ABHR, alcohol‐based hand rub; HH, hand hygiene; ICP, infection control preventionist; ICU, intensive care; ICU‐HAI, intensive care–related infection; IPL, infection prevention link nurse; SAI, antibiotic prescription‐based health care–acquired infection‐surveillance system.
FIGURE 2
FIGURE 2
The rate of ICU‐HAIs/1000 PDs, ABHR Consumption and Hand Hygiene Compliance. Note. ICU‐HAI (the intensive‐care‐related infection) rates are given as ICU‐HAIs/1000 patient days (PDs) and ABHR (alcohol‐based handrub) consumption is given as ABHR consumption/1000 PDs. The Rates of ABHR consumption/1000 patient days (PDs) and ICU‐HAIs/1000 PDs. The difference of % of HH Compliance was statistically significant (chi square p < 0.05).
FIGURE 3
FIGURE 3
Annual rates of ICU‐related BSIs, pneumonias and urinal catheter‐acquired urine infections. BSI, bloodstream infection; CAUTI, urethral catheter related urine infection; CVC, central venous catheter; ICU, intensive care; PD, patient day.
See this image and copyright information in PMC

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