Multimodal evaluation of the effectiveness of a hand hygiene educational campaign at a small animal veterinary teaching hospital.

OBJECTIVE

To determine the effect of an intervention (educational campaign) on hand hygiene (HH) and health-care workers' (HCWs') perceptions of HH.

DESIGN

Prospective observational study and cross-sectional survey.

SAMPLE

Observed opportunities for HH performed by HCWs before (n = 222) and after (249) intervention, measures of HH product usage, and surveys distributed to 300 HCWs.

PROCEDURES

Data were collected by means of direct observation, measurement of HH product consumption, and surveys of HCWs.

RESULTS

Adherence rates of HCWs for HH practices before and after the intervention were 27% (61/222 observations) and 29% (73/249 observations), respectively. Combined HH and glove use adherence rates before and after the intervention were 84% (186/222 observations) and 81% (201/249 observations), respectively. Before intervention, the highest combined HH and glove use adherence rate was detected for technicians (90% [57/63 observations]) and for opportunities after exposure to a patient's bodily fluids (100% [5/5 opportunities]). Rate of use of alcohol-based antimicrobial hand rubs (AHRs) and amount of HH products used did not significantly change during the study. Survey response rates were 41% (122) and 21% (62) before and after the intervention, respectively. Availability of AHRs and role modeling of HH (performance of HH each time it is warranted) were considered the factors most likely to increase HH adherence rates by survey respondents.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated the intervention did not increase HH adherence or use of AHRs. High rates of glove use before the start of the study may have been a confounding factor. Future educational campaigns should indicate that glove use should not supersede HH.