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Gwaikolo C, Bodo B, Nabawanuka D, Mukiibi M, Seremba E, Muyinda P, Bakainaga A, Woldemariam YT, Moore CC, Ssekitoleko R. Impact of supportive supervision visits on the availability of World Health Organization infection prevention and control core components in health facilities in Southwestern Uganda. Infect Prev Pract 2024; 6:100355. [PMID: 38854705 PMCID: PMC11156696 DOI: 10.1016/j.infpip.2024.100355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 06/11/2024] Open
Abstract
Background In sub-Saharan Africa, the provision of infection prevention and control (IPC) measures are often limited by resource constraints. Aim To determine the association of supportive supervision activities with the availability of the WHO core components for IPC at health facilities in Southwestern Uganda. Methods We employed a before and after quality improvement study design. We conducted a baseline assessment of the availability of the WHO IPC core components and provided supportive supervision activities, which was followed by a second IPC assessment. We included health centers II-IV, which have increasing clinical care capacity, and regional hospitals. Findings Of 244 regional health facilities, baseline assessment occurred at 111 (45%) of which 23 (21%) were reassessed. The number of facilities in the Red (<70%) category for each core component stayed the same or decreased at each facility type, but there was an increase from five to six health center III facilities scoring Red (<70%) for PPE. The number of facilities in the Green (>85%) category for each core component stayed the same or was increased at each facility type, but there was a decrease from four to two health center III facilities scoring Green (>85%) for instrument processing. There was an increase in the median (interquartile range [IQR]) overall score for all facilities (65 [54-72] vs 75 [68-83], P=0.0001). Conclusion Supportive supervision activities were associated with improved availability of the core components of IPC at health facilities in Southwestern Uganda. PPE should be prioritized in health care facilities in Southwestern Uganda.
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Affiliation(s)
- Cozie Gwaikolo
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | | | | | | | - Emmanuel Seremba
- College of Health Sciences, Makerere University, Kampala, Uganda
- Kiruddu National Hospital, Kampala, Uganda
| | - Paul Muyinda
- College of Education and External Studies, Makerere University, Kampala, Uganda
| | | | | | - Christopher C. Moore
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Matsuura T, Kyokane K, Yamada S, Kuno Y. The development of the cure of the functional intestinal disorder based on the differences of gut microbiota in aged patients: A randomized clinical trial. Medicine (Baltimore) 2021; 100:e27696. [PMID: 34871255 PMCID: PMC8568417 DOI: 10.1097/md.0000000000027696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/02/2021] [Accepted: 10/20/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Constipation, which is not an organic disease in the lower gastrointestinal tract, is a gastrointestinal symptom characteristic of elderly patients. Complaints of dyschezia increase with age, and it is difficult to treat in many cases. This study aimed to determine the appropriate treatment and its effects on intestinal immunity in elderly patients experiencing chronic constipation. METHODS Patients experiencing difficulty defecating were randomly divided into 2 groups. Group A was given only laxatives, whereas Group B was given laxatives combined with probiotics as an intervention. Both groups were compared based on the degree of improvement in constipation and its effects on the intestinal environment. RESULTS There was a significant improvement in constipation of elderly patients when probiotics were administered in combination with a laxative, suggesting that it may be a more effective treatment. Furthermore, the changes in the intestinal flora, examined before and after the intervention, tended to be associated with improvement of constipation. CONCLUSION The results indicated that the improvement of intestinal flora was somewhat achieved by relieving constipation. Because intestinal bacteria significantly influence intestinal immunity and, thus, systemic immunity of the entire body, the development of better treatments for constipation would help to improve both the intestinal environment and immune function in the elderly.
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Hansen S, Schwab F, Gastmeier P, Zingg W. Association of national and hospital factors to hospitals' alcohol-based handrub consumption in Europe: results of the European PROHIBIT study. Clin Microbiol Infect 2017; 24:778.e1-778.e6. [PMID: 29074159 DOI: 10.1016/j.cmi.2017.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Hand hygiene is considered the most effective way to reduce the transmission of (multidrug-resistant) organisms and to prevent healthcare-associated infections. Hand rubbing with alcohol-based handrub (AHR) has become the reference standard for hand hygiene. Data on AHR consumption are easy to obtain and can serve as an approximation for hand hygiene compliance. As described earlier, AHR consumption varies among European hospitals. In the current study the role of various hospital and country indicators for AHR consumption is analysed. METHODS As part of the European Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project hospital-based data on infection prevention and control (IPC) structure and organization and hospital-wide AHR consumption were obtained from acute care hospitals. National indicators such as income, public health expenditure, national hand hygiene campaigns, IPC training and the six Hofstede dimensions were identified. Univariable and multivariable linear regression analyses using generalized linear models were performed to estimate the association between AHR consumption and indicators at both hospital and country levels. RESULTS Data from 232 hospitals from 22 European countries were analysed. Multivariate risk factor analysis showed independent associations between AHR consumption and private and university-affiliated hospitals (multiplicative effect, 95% CI: 1.76, 1.21-2.55; and 1.39, 1.17-1.64, respectively), high-income countries (3.61, 2.94-4.43), and countries offering national curricula for the training of IPC nurses (3.77, 2.32-6.13). However, no cultural dimension was independently associated with AHR consumption. CONCLUSION Country indicators such as high-income, national training on IPC, and hospital type and status are positively associated with AHR consumption in Europe.
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Affiliation(s)
- S Hansen
- Charité-University Medicine Berlin, Institute for Hygiene, Berlin, Germany.
| | - F Schwab
- Charité-University Medicine Berlin, Institute for Hygiene, Berlin, Germany
| | - P Gastmeier
- Charité-University Medicine Berlin, Institute for Hygiene, Berlin, Germany
| | - W Zingg
- University of Geneva Hospitals, Infection Control Programme, Geneva, Switzerland
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Cheng VCC, Tai JWM, Li WS, Chau PH, So SYC, Wong LMW, Ching RHC, Ng MML, Ho SKY, Lee DWY, Lee WM, Wong SCY, Yuen KY. Implementation of directly observed patient hand hygiene for hospitalized patients by hand hygiene ambassadors in Hong Kong. Am J Infect Control 2016; 44:621-4. [PMID: 26777285 DOI: 10.1016/j.ajic.2015.11.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The importance of compliance with hand hygiene by patients is increasingly recognized to prevent health care-associated infections. METHODS This descriptive study observed the effects of an education campaign, targeted to increase patients' self-initiated hand hygiene, and a hand hygiene ambassador-initiated directly observed hand hygiene program on patients' hand hygiene compliance in a university-affiliated hospital. RESULTS The overall audited compliance of patients' self-initiated hand hygiene was only 37.5%, with a rate of 26.9% (112/416 episodes) before meals and medications, 27.5% (19/69 episodes) after using a urinal or bedpan, and 89.7% (87/97 episodes) after attending toilet facilities. Patients referred from a residential care home for older adults had significantly lower hand hygiene compliance (P = .007). Comparatively, the overall audited compliance of ambassador-initiated directly observed hand hygiene was 97.3% (428/440 episodes), which was significantly higher than patients' self-initiated hand hygiene via a patient education program (37.5%, 218/582 episodes, P < .001). CONCLUSIONS Directly observed hand hygiene can play an important role in improving compliance with hand hygiene by hospitalized patients.
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Affiliation(s)
- Vincent C C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Josepha W M Tai
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - W S Li
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - P H Chau
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Simon Y C So
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Lisa M W Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Radley H C Ching
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Modissa M L Ng
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Sara K Y Ho
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Doris W Y Lee
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - W M Lee
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Sally C Y Wong
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - K Y Yuen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
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Abstract
Purpose of review Hand hygiene and isolation are basic, but very effective, means of preventing the spread of pathogens in healthcare. Although the principle may be straightforward, this review highlights some of the controversies regarding the implementation and efficacy of these interventions. Recent findings Hand hygiene compliance is an accepted measure of quality and safety in many countries. The evidence for the efficacy of hand hygiene in directly reducing rates of hospital-acquired infections has strengthened in recent years, particularly in terms of reduced rates of staphylococcal sepsis. Defining the key components of effective implementation strategies and the ideal method(s) of assessing hand hygiene compliance are dependent on a range of factors associated with the healthcare system. Although patient isolation continues to be an important strategy, particularly in outbreaks, it also has some limitations and can be associated with negative effects. Recent detailed molecular epidemiology studies of key healthcare-acquired pathogens have questioned the true efficacy of isolation, alone as an effective method for the routine prevention of disease transmission. Summary Hand hygiene and isolation are key components of basic infection control. Recent insights into the benefits, limitations and even adverse effects of these interventions are important for their optimal implementation.
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Allegranzi B, Stewardson A, Pittet D. Nationwide Benchmarking of Hand Hygiene Performance. Infect Control Hosp Epidemiol 2015; 33:621-3. [DOI: 10.1086/665720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Davis R, Parand A, Pinto A, Buetow S. Systematic review of the effectiveness of strategies to encourage patients to remind healthcare professionals about their hand hygiene. J Hosp Infect 2014; 89:141-62. [PMID: 25617088 DOI: 10.1016/j.jhin.2014.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 11/19/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients could help to improve the hand hygiene (HH) compliance of healthcare professionals (HCPs) by reminding them to sanitize their hands. AIM To review the effectiveness of strategies aimed at increasing patient involvement in reminding HCPs about their HH. METHODS A systematic review was conducted across Medline, EMBASE and PsycINFO between 1980 and 2013. FINDINGS Twenty-eight out of a possible 1956 articles were included. Of these, 23 articles evaluated the effectiveness of developed patient-focused strategies and five articles examined patients' attitudes towards hypothetical strategies. Sixteen articles evaluated single-component strategies (e.g. videos) and 12 articles evaluated multi-modal approaches (e.g. combination of video and leaflet). Overall, the strategies showed promise in helping to increase patients' intentions and/or involvement in reminding HCPs about their HH. HCP encouragement appeared to be the most effective strategy. However, the methodological quality of the articles in relation to addressing the specific aims of this review was generally weak. CONCLUSION A number of strategies are available to encourage patients to question HCPs about their HH. Better controlled studies with more robust outcome measures will enhance understanding about which strategies may be most successful and why.
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Affiliation(s)
- R Davis
- Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
| | - A Parand
- Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - A Pinto
- Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - S Buetow
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand
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Limón-Ramírez R, Gea-Velázquez de Castro MT, Aranaz-Andrés JM. [Design of a multimodal strategy including health marketing for the improvement of hand hygiene fulfillment]. Med Clin (Barc) 2014; 142:505-11. [PMID: 24387954 DOI: 10.1016/j.medcli.2013.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/22/2013] [Accepted: 07/25/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Ramón Limón-Ramírez
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital de la Plana-Departament de Salut de la Plana, Vila-real, Castellón, España.
| | - María Teresa Gea-Velázquez de Castro
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital Universitari de Sant Joan d'Alacant-Departament de Salut de Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España
| | - Jesús María Aranaz-Andrés
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital Universitari de Sant Joan d'Alacant-Departament de Salut de Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), España
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Allegranzi B, Conway L, Larson E, Pittet D. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities. Am J Infect Control 2014; 42:224-30. [PMID: 24581011 DOI: 10.1016/j.ajic.2013.11.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/05/2013] [Accepted: 11/19/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. METHODS From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. RESULTS Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). CONCLUSION Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign.
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Affiliation(s)
- Benedetta Allegranzi
- First Global Patient Safety Challenge, World Health Organization Patient Safety Program, World Health Organization, Geneva, Switzerland
| | - Laurie Conway
- Columbia University School of Nursing, Columbia University, New York, NY
| | - Elaine Larson
- Columbia University School of Nursing, Columbia University, New York, NY
| | - Didier Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Latham JR, Magiorakos AP, Monnet DL, Alleaume S, Aspevall O, Blacky A, Borg M, Ciurus M, Costa AC, Cunney R, Dolinšek M, Dumpis U, Erne S, Gudlaugsson O, Hedlova D, Heisbourg E, Holt J, Kerbo N, Sorknes NK, Lyytikäinen O, Maltezou HC, Michael S, Moro ML, Reichardt C, Stefkovicova M, Szilágyi E, Valinteliene R, Vatcheva-Dobrevska R, Viseur N, Voss A, Woodward S, Cordier L, Jansen A. The role and utilisation of public health evaluations in Europe: a case study of national hand hygiene campaigns. BMC Public Health 2014; 14:131. [PMID: 24507086 PMCID: PMC3931350 DOI: 10.1186/1471-2458-14-131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 01/27/2014] [Indexed: 11/23/2022] Open
Abstract
Background Evaluations are essential to judge the success of public health programmes. In Europe, the proportion of public health programmes that undergo evaluation remains unclear. The European Centre for Disease Prevention and Control sought to determine the frequency of evaluations amongst European national public health programmes by using national hand hygiene campaigns as an example of intervention. Methods A cohort of all national hand hygiene campaigns initiated between 2000 and 2012 was utilised for the analysis. The aim was to collect information about evaluations of hand hygiene campaigns and their frequency. The survey was sent to nominated contact points for healthcare-associated infection surveillance in European Union and European Economic Area Member States. Results Thirty-six hand hygiene campaigns in 20 countries were performed between 2000 and 2012. Of these, 50% had undergone an evaluation and 55% of those utilised the WHO hand hygiene intervention self-assessment tool. Evaluations utilised a variety of methodologies and indicators in assessing changes in hand hygiene behaviours pre and post intervention. Of the 50% of campaigns that were not evaluated, two thirds reported that both human and financial resource constraints posed significant barriers for the evaluation. Conclusion The study identified an upward trend in the number of hand hygiene campaigns implemented in Europe. It is likely that the availability of the internationally-accepted evaluation methodology developed by the WHO contributed to the evaluation of more hand hygiene campaigns in Europe. Despite this rise, hand hygiene campaigns appear to be under-evaluated. The development of simple, programme-specific, standardised guidelines, evaluation indicators and other evidence-based public health materials could help promote evaluations across all areas of public health.
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Affiliation(s)
- Jonathan R Latham
- Office of the Chief Scientist, European Centre for Disease Prevention and Control, Tomtebodavägen 11A, SE-171 83 Stockholm, Sweden.
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Hübner NO, Hübner C, Kramer A. Impact of health campaign on hand hygiene with alcohol-based hand rubs in a non-clinical setting. J Hosp Infect 2013; 83 Suppl 1:S23-8. [PMID: 23453172 DOI: 10.1016/s0195-6701(13)60006-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Hand hygiene has been acknowledged as the single most important measure to prevent nosocomial infections. Likewise, for non-clinical settings, hand hygiene is recognized as a key element to prevent the spread of infectious diseases, nevertheless poor compliance has been documented. The feasibility of hand hygiene interventions in open-community settings with adults is mostly unclear. AIM To investigate the acceptability and feasibility of a health campaign to promote hand hygiene with alcohol-based hand disinfectants at workplaces in a non-clinical setting. METHODS The surveys were conducted as part of a prospective, controlled intervention study with volunteers from the administration of the Ernst-Moritz-Arndt-University Greifswald, the municipality of Greifswald and the state of Mecklenburg-West Pomerania. Participants in the intervention group were provided with alcohol-based hand disinfection; the control group was unchanged. Eleven volunteers filled out an initial survey at the beginning of the intervention regarding demographic and health-related questions as well as questions about the type of work, and a survey after completion of the intervention to evaluate the study's impact on the participants' attitudes toward hand hygiene. Participants in the experimental group filled out a monthly questionnaire regarding their compliance with hand hygiene measures, feasibility of hand disinfection and possible side-effects. FINDINGS From 850 employees asked to participate, 134 were included in the study, and surveys from 129 participants (intervention: 64 vs control: 65) were accepted for analysis. Overall, datasets of 1230 person-months (79.46% of total possible follow-up surveys) were collected. Return rate and compliance remained high during the study period. Hand disinfection did not lead to skin problems in the majority of person-months. After the intervention, a majority of participants would favour a further use of hand disinfectants. CONCLUSION Campaigns that enforce the use of alcohol-based hand disinfectants can have a sustainable effect on the compliance with hand hygiene measures in non-clinical settings. Campaigns have been shown to be feasible and effective in the prevention of transmissible diseases, therefore employers should consider whether hand hygiene campaigns to introduce waterless hand rubs could be included in companies' health programmes.
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Affiliation(s)
- N-O Hübner
- Institute of Hygiene and Environmental Medicine, University Hospital of Greifswald, Germany.
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What can we learn from each other in infection control? Experience in Europe compared with the USA. J Hosp Infect 2013; 83:173-84. [DOI: 10.1016/j.jhin.2012.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 12/06/2012] [Indexed: 11/22/2022]
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Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. J Hosp Infect 2013; 83 Suppl 1:S3-10. [DOI: 10.1016/s0195-6701(13)60003-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Pre-operative skin preparation practices: results of the 2007 French national assessment. J Hosp Infect 2012; 81:58-65. [DOI: 10.1016/j.jhin.2011.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 12/31/2011] [Indexed: 11/19/2022]
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Stewardson A, Allegranzi B, Sax H, Kilpatrick C, Pittet D. Back to the future: rising to the Semmelweis challenge in hand hygiene. Future Microbiol 2011; 6:855-76. [PMID: 21861619 DOI: 10.2217/fmb.11.66] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hand hygiene is the single most important intervention for reducing healthcare associated infections and preventing the spread of antimicrobial resistance. This sentence begins most publications regarding hand hygiene in the medical literature. But why - as we mark 150 years since the publication of Ignaz Semmelweis' landmark monograph on the subject - do we continue to repeat it? One might be tempted to regard it as a truism. However, while tremendous progress has certainly been made in this field, a significant amount of work is yet to be done in both strengthening the evidence regarding the impact of hand hygiene and maximizing its implementation. Hand hygiene cannot yet be taken for granted. This article summarizes historical perspectives, dynamics of microbial colonization and efficacy of hand cleansing methods and agents, elements and impacts of successful hand hygiene promotion, as well as scale-up and sustainability. We also explore hand hygiene myths and current challenges such as monitoring, behavior change, patient participation and research priorities.
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Affiliation(s)
- Andrew Stewardson
- Infection Control Program & World Health Organization Collaborating Centre on Patient Safety (Infection Control & Practice Improvement), University of Geneva Hospitals, Switzerland
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Stackelroth J, Shaban RZ. The challenges of implementing a national hand hygiene initiative in rural and remote areas: Is it time for a new approach to auditing? ACTA ACUST UNITED AC 2011. [DOI: 10.1071/hi11001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Stone S, Gallagher R, Storr J, Tanner G. Campaigns and continuity. THE LANCET. INFECTIOUS DISEASES 2011; 11:340-1. [PMID: 21530887 DOI: 10.1016/s1473-3099(11)70095-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sheldon Stone
- Royal Free Campus, University College London Medical School, London NW3 2PF, UK.
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