Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado.
University of Colorado Health, Aurora, Colorado.
Infect Control Hosp Epidemiol. 2020 Aug;41(8):931-937. doi: 10.1017/ice.2020.182. Epub 2020 May 28.
Hand hygiene adherence has been associated with reductions in nosocomial infection. We assessed the effect of improvements in electronically measured hand hygiene adherence on the incidence of hospital-acquired infections.
This quasi-experimental study was conducted in a 555-bed urban safety-net level I trauma center. The preintervention period was January 2015 through June 2016. Baseline electronic hand hygiene data collection took place from April through June 2016. The intervention period was July 2016 through December 2017. An electronic hand hygiene system was installed in 4 locations in our hospital. Performance improvement strategies were implemented that included education, troubleshooting, data dissemination, and feedback. Adherence rates were tracked over time. Rates of hospital-acquired infections were evaluated in the intervention units and in control units selected for comparison. The intervention period was subdivided into the initial and subsequent 9-month periods and were compared to the baseline period.
Electronically measured hand hygiene rates improved significantly from baseline to intervention, from 47% 77% adherence. Rates >70% continued to be measured 18 months after the intervention. Interrupted time series analysis indicated a significant effect of hand hygiene on healthcare facility-onset Clostridioides difficile infection rates during the first 9 months of the intervention. This trend continued during the final 9 months of the intervention but was nonsignificant. No effects were observed for other hospital-acquired infection rates.
Implementation of electronic hand hygiene monitoring and performance improvement interventions resulted in reductions in hospital-onset Clostridioides difficile infection rates.
手部卫生依从性与医院感染的减少有关。我们评估了电子测量的手部卫生依从性提高对医院获得性感染发生率的影响。
这是一项在 555 张床位的城市安全网一级创伤中心进行的准实验研究。干预前时期为 2015 年 1 月至 2016 年 6 月。基线电子手部卫生数据收集于 2016 年 4 月至 6 月进行。干预期为 2016 年 7 月至 2017 年 12 月。我们医院的 4 个地点安装了电子手部卫生系统。实施了绩效改进策略，包括教育、故障排除、数据传播和反馈。随着时间的推移，跟踪了依从率。在干预单位和为比较而选择的对照单位评估了医院获得性感染的发生率。干预期分为初始和随后的 9 个月期，并与基线期进行了比较。
从基线到干预，电子测量的手部卫生依从率从 47%显著提高到 77%。在干预后 18 个月，仍有 70%以上的患者进行了测量。中断时间序列分析表明，在干预的前 9 个月，手部卫生对医疗保健机构发生的艰难梭菌感染率有显著影响。这一趋势在干预的最后 9 个月持续存在，但无统计学意义。其他医院获得性感染率没有观察到影响。
电子手部卫生监测和绩效改进干预的实施导致医院获得性艰难梭菌感染率降低。
