Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel

Background. Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor. Objective. To assess short- and long-term ef...

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Veröffentlicht in:Infection control and hospital epidemiology 2012-02, Vol.33 (2), p.144-151
Hauptverfasser: Aboumatar, Hanan, Ristaino, Polly, Davis, Richard O., Thompson, Carol B., Maragakis, Lisa, Cosgrove, Sara, Rosenstein, Beryl, Perl, Trish M.
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Sprache:eng
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Zusammenfassung:Background. Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor. Objective. To assess short- and long-term effects of an infection prevention promotion program on healthcare personnel hand hygiene behaviors. Design. Time series design. Setting Our study was conducted at a tertiary care academic center. Participants. Hospital healthcare personnel. Methods. We developed a multimodal program that included a multimedia communications campaign, education, leadership engagement, environment modification, team performance measurement, and feedback. Healthcare personnel hand hygiene practices were measured via direct observations over a 3-year period by “undercover” observers. Results. Overall hand hygiene compliance increased by 2-fold after full program implementation ( ), and this increase was sustained over a 20-month follow-up period ( ). The odds for compliance with hand hygiene increased by 3.8-fold in the 6 months after full program implementation (95% confidence interval, 3.53–4.23; ), and this increase was sustained. There was even a modest increase at 20 months of follow up. Hand hygiene compliance increased among all disciplines and hospital units. Hand hygiene compliance increased from 35% in the first 6 months after program initiation to 77% in the last 6 months of the study period among nursing providers ( ), from 38% to 62% among medical providers ( ), and from 27% to 75% among environmental services staff ( ). Conclusions. Implementation of the infection prevention promotion program was associated with a significant and sustained increase in hand hygiene practices among healthcare personnel of various disciplines.
ISSN:0899-823X
1559-6834
DOI:10.1086/663707