Division of Infection Control and Prevention, International University of Health and Welfare Graduate School, Tokyo, Japan.
Division of Infection Control and Prevention, Mito Kyodo General Hospital, University of Tsukuba, Mito, Ibaraki, Japan.
Am J Infect Control. 2020 Jan;48(1):77-81. doi: 10.1016/j.ajic.2019.06.017. Epub 2019 Jul 23.
Our goal was to evaluate the 5-year sustainability of a multimodal intervention that included a prize to the hospital with the highest overall hand hygiene adherence rates among health care workers.
We conducted an observational study in 3 Japanese tertiary care hospitals using unobtrusive direct observation of physician and nurse hand hygiene adherence. Observations were performed by a trained observer on inpatient medical, surgical, intensive care, and emergency units. The primary outcome was hand hygiene adherence rates before patient contact. Secondary outcomes were health care worker survey responses to a World Health Organization (WHO) questionnaire on hand hygiene practices.
Hand hygiene adherence rates had improved significantly after the introduction of a multimodal intervention (based on principles recommend by the WHO) in 2012 and 2013 (from 18.0% pre-intervention to 32.7% 6 months post-intervention; P < .001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5 years after intervention; P = .53); however, substantial variability in hand hygiene adherence by unit and health care worker type was noted.
A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention.
我们的目标是评估一项多模式干预措施的 5 年可持续性，该措施包括向医护人员整体手卫生依从率最高的医院颁发奖项。
我们在日本的 3 家三级保健医院进行了一项观察性研究，采用不引人注目的直接观察医生和护士的手卫生依从性。观察由一名经过培训的观察员在住院内科、外科、重症监护和急诊病房进行。主要结局是接触患者前的手卫生依从率。次要结局是医护人员对世界卫生组织（WHO）手卫生实践问卷的回答。
在 2012 年和 2013 年引入多模式干预措施（基于 WHO 推荐的原则）后，手卫生依从率显著提高（干预前为 18.0%，干预后 6 个月为 32.7%；P <.001）。在最初干预 5 年后，这些医院的手卫生依从率没有明显变化（干预后 5 年为 31.9%；P = .53）；然而，注意到手卫生依从性在各单位和医护人员类型之间存在显著差异。
一项多模式手卫生倡议在最初干预 5 年后，使 3 家日本医院的手卫生依从率持续提高。
