Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities

Background:Health care-associated infection remains a significant hazard for hospitalized patients. Hand hygiene is a fundamental action for ensuring patient safety.Objective:To promote adoption of World Health Organization Hand Hygiene Guidelines to enhance compliance among doctors and nurses and improve patient safety.Methods:The study design was a cross sectional intervention in a Federal Teaching Hospital South-eastern Nigeria. Interventions involved training/education; introduction of hand rub; and hand hygiene reminders. The impact of interventions and hand hygiene compliance were evaluated using World Health Organization direct observation technique.Results:The post-intervention hand hygiene compliance rate was 65.3%. Hand hygiene indications showed highest compliance rate &#8216;after body fluid exposure&#8217; (75.3%) and &#8216;after touching a patient&#8217; (73.6%) while the least compliance rate was recorded &#8216;before touching a patient&#8217; (58.0%). Hand hygiene compliance rate was significantly higher among nurses (72.9%) compared to doctors (59.7%) (&#967;2 = 23.8, p< 0.05). Hand hygiene indication with significantly higher compliance rate was &#8220;before clean/aseptic procedure&#8221; (84.4%) (&#967;2 = 80.74, p < 0.05). Out of the 815 hand hygiene practices recorded 550 (67.5%) were hand rub action.Conclusions:hand hygiene campaigns using the World Health Organization tools and methodology can be successfully executed in a tertiary health facility of a low-income setting with far reaching improvements in compliance

A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial

Issue: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1–3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. Initial assessment: In order to estimate the effect of a multimodal intervention on improving healthcare workers’ compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. Choice of solution and implementation: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). Evaluation: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13–1.22). The effect was still present after adjustment by calendar’s time and providers’ characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03–1.14). Lessons learned: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Giuffre, Carolina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Villa, Silvia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Almada, Griselda. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Prasopa Plaizier, Nittita. Instituto de Efectividad Clínica y Sanitaria; Argentina. World Health Organization; SuizaFil: Gogna, Monica Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Argentinian Group Hand Hygiene Improvement. No especifica

Enhancing foodborne disease surveillance across Australia in 2001: the OzFoodNet Working Group

In 2000, the OzFoodNet network was established to enhance surveillance of foodborne diseases across Australia. OzFoodNet consists of 7 sites and covers 68 per cent of Australia's population. During 2001, sites reported 15,815 cases of campylobacteriosis