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Behavior-Based Interventions to Improve Hand Hygiene Adherence Among Intensive Care Unit Healthcare Workers in Thailand

Published online by Cambridge University Press:  04 February 2015

Anucha Apisarnthanarak ,
Thanee Eiamsitrakoon  and
Linda M. Mundy
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Thanee Eiamsitrakoon
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Linda M. Mundy
Affiliation:
GlaxoSmithKline, Collegeville, Pennsylvania
*
Address correspondence to Anucha Apisarnthanarak, MD, Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand, 10120 ([email protected]).
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Abstract

OBJECTIVE

To evaluate behavioral-based interventions to improve hand hygiene (HH) among healthcare workers (HCWs) at a Thai tertiary care center.

METHODS

A quasi-experimental study was performed in 6 intensive care units with computer-generated allocation. Baseline demographic characteristics, self-reported stage of HH behavioral commitment, and observed HH adherence were examined from January 1, 2012, through December 31, 2012 (preintervention), and from January 1, 2013, through December 31, 2013 (postintervention). Self-reported HH was categorized by the stages construct from the Transtheoretical Model of Health Behavior Change. The intensive care unit group randomization was to either standard-of-care HH education every 3 months (S1), intensified HH interventions (S2), or intensified HH interventions plus increased availability of alcohol-based handrub throughout the unit (S3).

RESULTS

Among125 HCWs from 6 intensive care units (42 in S1, 41 in S2, 42 in S3) there were 1,936 total HH observations; most HCWs (100 [ 80%]) were nurses or nurse assistants. Compared with preintervention, overall postintervention HH adherence improved in HCWs assigned to S2 (65% vs 85%; P=.02) and S3 (66% vs 95%; P=.005) but not S1 (68% vs 71%; P=.84). Improvement in HH adherence was demonstrated among HCWs who reported lower stages of HH commitment in S2 (21% vs 84%; P<.001) and S3 (24% vs 89%; P<.001) and in HCWs who self-reported higher stages of commitment in S3 (78% vs 96%; P<.001).

CONCLUSIONS

HCW HH programs may benefit from stage-based tailored strategies to promote sustained HH adherence.

Infect Control Hosp Epidemiol 2015;00(0): 1–5

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 5 , May 2015 , pp. 517 - 521
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

1. Pittet, D, Allegranzi, B, Boyce, J. The World Health Organization guidelines on hand hygiene in heath care and their consensus recommendations. Infect Control Hosp Epidemiol 2009;30:611–622.CrossRefGoogle Scholar
2. World Health Organization. WHO Guidelines on Hand Hygiene in Healthcare. Geneva: World Health Organization Press, 2009.Google Scholar
3. Erasmus, V, Daha, TJ, Brug, H, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010;31:283–294.CrossRefGoogle ScholarPubMed
4. Eiamsitrakoon, T, Apisarnthanarak, A, Nuallaong, W, Khawcharoenporn, T, Mundy, LM. Hand hygiene behavior: translating behavioral research into infection control practice. Infect Control Hosp Epidemiol 2013;34:1137–1145.CrossRefGoogle ScholarPubMed
5. Sax, H, Uçkay, I, Richet, H, Allegranzi, B, Pittet, D. Determinants of good adherence to hand hygiene among healthcare workers who have extensive exposure to hand hygiene campaigns. Infect Control Hosp Epidemiol 2007;28:1267–1274.CrossRefGoogle ScholarPubMed
6. Marra, AR, Guastelli, LR, de Araújo, CM, et al. Positive deviance: a new strategy for improving hand hygiene compliance. Infect Control Hosp Epidemiol 2010;31:12–20.CrossRefGoogle ScholarPubMed
7. Fuller, C, Michie, S, Savage, J, et al. The Feedback Intervention Trial (FIT)-improving hand-hygiene compliance in UK healthcare workers: a stepped wedge cluster randomised controlled trial. PLoS One 2012;7:e41617.CrossRefGoogle ScholarPubMed
8. Marra, AR, Sampaio Camargo, TZ, Magnus, TP, et al. The use of real-time feedback via wireless technology to improve hand hygiene compliance. Am J Infect Control 2014;42:608–611.CrossRefGoogle ScholarPubMed
9. Marra, AR, Edmond, MB. New technologies to monitor healthcare worker hand hygiene. Clin Microbiol Infect 2014;20:29–33.CrossRefGoogle ScholarPubMed
10. Sax, H, Allegranzi, B, Chraïti, MN, Boyce, J, Larson, E, Pittet, D. The World Health Organization hand hygiene observation method. Am J Infect Control 2009;37:827–834.CrossRefGoogle ScholarPubMed
11. Marra, AR, Noritomi, DT, Westheimer Cavalcante, AJ, et al. A multicenter study using positive deviance for improving hand hygiene compliance. Am J Infect Control 2013;41:984–988.CrossRefGoogle ScholarPubMed
12. Schweizer, ML, Reisinger, HS, Ohl, M, et al. Searching for an optimal hand hygiene bundle: a meta-analysis. Clin Infect Dis 2014;58:248–259.CrossRefGoogle ScholarPubMed
13. Al-Tawfiq, JA, Pittet, D. Improving hand hygiene compliance in healthcare settings using behavior change theories: reflections. Teach Learn Med 2013;25:274–282.CrossRefGoogle ScholarPubMed
14. Harris, AD, Bradham, DD, Baumgarten, M, Zuckerman, IH, Fink, JC, Perencevich, EN. The use and interpretation of quasi-experimental studies in infectious diseases. Clin Infect Dis 2004;38:1586–1591.Google ScholarPubMed