Thomas Alphonsa Muth, Kaur Sukhwinder, Biswal Manisha, N Rao K L, Vig Shashi
National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Med Microbiol. 2019 Oct-Dec;37(4):496-501. doi: 10.4103/ijmm.IJMM_20_47.
The WHO Multimodal Hand Hygiene Improvement Strategy (MHHIS) has been proposed to improve the Hand Hygiene (HH) compliance of the WHO recommendations on HH.Therefore, the current study was planned in our neonatal unit with the objective of evaluating the effectiveness of a Hand Hygiene Promotional Program (HHPP) based on the WHO MHHIS, in terms of compliance and decontamination efficacy among the health-care workers (HCWs) in the unit.
The objective of the study was to evaluate the effectiveness of the WHO MHHIS on HH compliance and decontamination efficacy.
The HHPP was carried out in our neonatal surgical intensive care unit from July to August 2013. A pre-intervention phase consisted of assessment of ward infrastructure, HH knowledge and perception, determination of HH compliance and collection of hand rinse samples from the HCWs before and after handwashing. Intervention phase consisted of changing traditional to elbow-operated taps, display of posters and reminders, placement of soaps in water draining trays, autoclaved single-use paper towels for hand drying, availability of hand rubs and training sessions for health-care providers. In the post-intervention phase, all the assessments and observations of pre-intervention phase were repeated.
HHPP resulted in a significant increase in overall HH compliance from 26.6% (95% confidence interval [CI] 23.9-29.3) to 65.3% (95% CI 62.4-68.2) (P < 0.001) and reduction in load of microorganisms (P = 0.013). There was a significant improvement in HH knowledge (P < 0.001), and perception surveys revealed high appreciation of each strategy component by the participants.
To the best of our knowledge, this is the first study about the effect of implementation of the WHO MHHIS from an Indian hospital. HHPP was found to be effective in terms of HH compliance and decontamination efficacy. Its implementation is highly recommended to promote HH in a developing country like India.
世界卫生组织多模式手卫生改善策略（MHHIS）已被提出，以提高手卫生（HH）对世界卫生组织HH建议的依从性。因此，我们在新生儿病房开展了本研究，目的是评估基于世界卫生组织MHHIS的手卫生促进计划（HHPP）在该病房医护人员（HCWs）中的依从性和去污效果方面的有效性。
本研究的目的是评估世界卫生组织MHHIS在HH依从性和去污效果方面的有效性。
2013年7月至8月在我们的新生儿外科重症监护病房开展HHPP。干预前阶段包括评估病房基础设施、HH知识和认知、确定HH依从性以及在医护人员洗手前后采集洗手水样。干预阶段包括将传统水龙头更换为肘动式水龙头、张贴海报和提示、在排水盘中放置肥皂、提供高压灭菌的一次性纸巾用于擦干双手、提供手消毒剂以及为医护人员开展培训课程。在干预后阶段，重复干预前阶段的所有评估和观察。
HHPP使总体HH依从性从26.6%（95%置信区间[CI]23.9 - 29.3）显著提高到65.3%（95%CI 62.4 - 68.2）（P < 0.001），微生物负荷降低（P = 0.013）。HH知识有显著改善（P < 0.001），认知调查显示参与者对每个策略组成部分高度认可。
据我们所知，这是来自印度一家医院关于实施世界卫生组织MHHIS效果的首次研究。发现HHPP在HH依从性和去污效果方面是有效的。强烈建议在像印度这样的发展中国家实施该计划以促进手卫生。
