Train-the-trainers in hand hygiene : a standardized approach to guide education in infection prevention and control

Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries.Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training.Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively.Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.peer-reviewe

Ten years of hand hygiene excellence : a summary of outcomes, and a comparison of indicators, from award-winning hospitals worldwide

Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing hand hygiene improvement programmes, including the World Health Organisation’s Multimodal Improvement Strategy. This study aimed at summarising the results of the HHEA campaign between 2010 and 2021 and investigating the relationship between different hand hygiene parameters based on data from participating healthcare facilities. Methods A retrospective analysis was performed on datasets from HHEA forms, including data on hand hygiene compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. Descriptive statistics were reported for each variable. The correlation between variables was inspected through Kendall’s test, while possible non-linear relationships between hand hygiene compliance, ABHR consumption and HHSAF scores were sought through the Locally Estimated Scatterplot Smoothing or logistic regression models. A tree-structured partitioning model was developed to further confirm the obtained findings. Results Ninety-seven healthcare facilities from 28 countries in three world regions (Asia-Pacific, Europe, Latin America) were awarded the HHEA and thus included in the analysis. HHSAF scores indicated an advanced hand hygiene promotion level (median 445 points, IQR 395–480). System change (100 [95–100] points) and institutional safety climate (85 [70–95] points) showed the highest and lowest score, respectively. In most cases, hand hygiene compliance was above 70%, with heterogeneity between countries. ABHR consumption above 20 millilitres per patient-day (ml/PD) was widely reported, with overall increasing trends. HHSAF scores were positively correlated with hand hygiene compliance (τ = 0.211, p = 0.007). We observed a positive correlation between compliance rates and ABHR consumption (τ = 0.193, p < 0.001), although the average predicted consumption was stable around 55–60 ml/PD for compliance rates above 80–85%. Logistic regression and partitioning tree analyses revealed that higher HHSAF scores were more likely in the high-ABHR consumption group at cut-offs around 57–59 ml/PD. Conclusion Ten years after its inception, the HHEA proves to be a valuable hand hygiene improvement programme in healthcare facilities worldwide. Consistent results were provided by the different hand hygiene indicators and the HHSAF score represents a valuable proxy measure of hand hygiene compliance.peer-reviewe

Correction to : Train-the-trainers in hand hygiene : a standardized approach to guide education in infection prevention and control

Correction to: Antimicrob Resist Infect Control https://doi.org/10.1186/s13756-019-0666-4 The original article [1] contained a misspelling in author, Fernando Bellissimo-Rodrigues’s name which has since been corrected.peer-reviewe

Educational initiatives aimed at medical and nursing staff to lower blood tract infections related to central venous catheters

Introducción. La bacteriemia relacionada a Catéter Venoso  Central  es una de las principales complicaciones en los pacientes a quienes se les instala un catéter intravascular. Las acciones educativas han mostrado disminución en la tasa de estas infecciones en diferentes estudios.  El objetivo fue determinar la tasa de Infecciones del tracto sanguíneo relacionadas al catéter venoso central (ITS/CVC), en el Servicio de Cuidado Intensivo Neonatal, implementar las acciones preventivas y cuantificar el impacto.Metodología. Es un estudio descriptivo en donde se compara la tasa de ITS/CVC, antes y después de una intervención educativa, en  los pacientes ingresados a SECIN.  La tasa de ITS/CVC  se obtuvo dividiendo el número de éstas entre el número de días-catéter y se multiplicó por 1 000.Resultado. Un resultado relevante es que en el periodo  pre intervención se observa una  tasa  de 32,84 infecciones por 1 000 días (cuarto trimestre del 2012 y primer trimestre del 2013)  y en el periodo post intervención la tasa fue de 8,28 infecciones por 1 000 días. (Tercer trimestre y cuarto trimestre del 2013).Conclusión. Se concluye que las acciones educativas para disminuir la tasa de ITS/CVC fueron efectivas.Introduction. Intravascular catheter-related infection is the major complication in patients with intravascular catheter. Intravascular catheter-related infection rate is derived by dividing the number of these infections between day-line vascular catheters and multiplied x 1 000. Educational initiatives decrease the rate of intravascular catheter-related infections according to different studies. Objectives: To determine the rate of STI / CVC in the Neonatal Intensive Care Service, implement preventive actions and quantify the impact.Methods. We compared the rate of intravascular catheter-related infections before and after an educational intervention.Results. In the pre intervention period a rate of 32.84 infections per 1,000 observed days (fourth quarter 2012 and first quarter of 2013) and in the post intervention period the rate is 8.28 infections per 1000 days. (Third quarter and fourth quarter of 2013).infections in 2 850 catheter-days and the rate decreased to 5.6, which was statistically significant.Conclusions. Educational initiatives aimed at decreasing the rate of intravascular catheter-related infections were shown to be effective

Acciones educativas dirigidas al personal médico y de enfermería para disminuir las infecciones del tracto sanguíneo relacionadas a catéteres venosos centrales

Introduction. Intravascular catheter-related infection is the major complication in patients with intravascular catheter. Intravascular catheter-related infection rate is derived by dividing the number of these infections between day-line vascular catheters and multiplied x 1 000. Educational initiatives decrease the rate of intravascular catheter-related infections according to different studies. Objectives: To determine the rate of STI / CVC in the Neonatal Intensive Care Service, implement preventive actions and quantify the impact.Methods. We compared the rate of intravascular catheter-related infections before and after an educational intervention.Results. In the pre intervention period a rate of 32.84 infections per 1,000 observed days (fourth quarter 2012 and first quarter of 2013) and in the post intervention period the rate is 8.28 infections per 1000 days. (Third quarter and fourth quarter of 2013).infections in 2 850 catheter-days and the rate decreased to 5.6, which was statistically significant.Conclusions. Educational initiatives aimed at decreasing the rate of intravascular catheter-related infections were shown to be effective.Introducción. La bacteriemia relacionada a Catéter Venoso  Central  es una de las principales complicaciones en los pacientes a quienes se les instala un catéter intravascular. Las acciones educativas han mostrado disminución en la tasa de estas infecciones en diferentes estudios.  El objetivo fue determinar la tasa de Infecciones del tracto sanguíneo relacionadas al catéter venoso central (ITS/CVC), en el Servicio de Cuidado Intensivo Neonatal, implementar las acciones preventivas y cuantificar el impacto.Metodología. Es un estudio descriptivo en donde se compara la tasa de ITS/CVC, antes y después de una intervención educativa, en  los pacientes ingresados a SECIN.  La tasa de ITS/CVC  se obtuvo dividiendo el número de éstas entre el número de días-catéter y se multiplicó por 1 000.Resultado. Un resultado relevante es que en el periodo  pre intervención se observa una  tasa  de 32,84 infecciones por 1 000 días (cuarto trimestre del 2012 y primer trimestre del 2013)  y en el periodo post intervención la tasa fue de 8,28 infecciones por 1 000 días. (Tercer trimestre y cuarto trimestre del 2013).Conclusión. Se concluye que las acciones educativas para disminuir la tasa de ITS/CVC fueron efectivas