The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial
Abstract Background The primary goal of hand hygiene is to reduce infectious disease rates. We examined if a nursing home’s participation in a hand hygiene intervention resulted in residents having fewer healthcare associated infections (HAIs) when compared to nursing homes without the hand hygiene...
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | https://doi.org/10.1186/s13756-021-00946-3 |
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| author | G. R. Teesing J. H. Richardus D. Nieboer M. Petrignani V. Erasmus A. Verduijn-Leenman J. M. G. A. Schols M. P. G. Koopmans M. C. Vos H. A. C. M. Voeten |
| author_facet | G. R. Teesing J. H. Richardus D. Nieboer M. Petrignani V. Erasmus A. Verduijn-Leenman J. M. G. A. Schols M. P. G. Koopmans M. C. Vos H. A. C. M. Voeten |
| author_sort | G. R. Teesing |
| collection | DOAJ |
| description | Abstract Background The primary goal of hand hygiene is to reduce infectious disease rates. We examined if a nursing home’s participation in a hand hygiene intervention resulted in residents having fewer healthcare associated infections (HAIs) when compared to nursing homes without the hand hygiene intervention. Methods This study is a part of a cluster randomized controlled trial (RCT) in 33 nursing homes to improve hand hygiene (HANDSOME). The incidence of five illnesses was followed over 13 months: gastroenteritis, influenza-like illness, pneumonia, urinary tract infections and infections from methicillin-resistant Staphylococcus aureus (MRSA). Incidence rates per study arm were reported for baseline (October–December 2016) and two follow-up periods (January–April 2017, May–October 2017). HAI rates were compared in a Poisson multilevel analysis, correcting for baseline differences (the baseline infection incidence and the size of the nursing home), clustering of observations within nursing homes, and period in the study. Results There was statistically significantly more gastroenteritis (p < 0.001) and statistically significantly less influenza-like illness (p < 0.01) in the intervention arm when compared to the control arm. There were no statistically significant differences or pneumonia, urinary tract infections, and MRSA infections in the intervention arm when compared to the control arm. In a sensitivity analysis, gastroenteritis was no longer statistically significantly higher in the intervention arm (p = 0.92). Conclusions As in comparable studies, we could not conclusively demonstrate the effectiveness of an HH intervention in reducing HAIs among residents of nursing homes, despite the use of clearly defined outcome measures, a standardized reporting instrument, and directly observed HH in a multicenter cluster RCT. Trial registration Netherlands Trial Register, trial NL6049 (NTR6188). Registered October 25, 2016, https://www.trialregister.nl/trial/6049 . |
| first_indexed | 2024-12-21T23:49:44Z |
| format | Article |
| id | doaj.art-26afdf1ea1ce43d5a6fd20a618f80a6d |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-21T23:49:44Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-26afdf1ea1ce43d5a6fd20a618f80a6d2022-12-21T18:45:58ZengBMCAntimicrobial Resistance and Infection Control2047-29942021-05-011011910.1186/s13756-021-00946-3The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trialG. R. Teesing0J. H. Richardus1D. Nieboer2M. Petrignani3V. Erasmus4A. Verduijn-Leenman5J. M. G. A. Schols6M. P. G. Koopmans7M. C. Vos8H. A. C. M. Voeten9Department of Public Health, Erasmus MC, University Medical Center RotterdamDepartment of Public Health, Erasmus MC, University Medical Center RotterdamDepartment of Public Health, Erasmus MC, University Medical Center RotterdamMunicipal Public Health Service AmsterdamDepartment of Public Health, Erasmus MC, University Medical Center RotterdamPieter Van ForeestDepartment Health Services Research, CAPHRI, Maastricht UniversityDepartment of Viroscience, Erasmus MC, University Medical Center RotterdamDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center RotterdamDepartment of Public Health, Erasmus MC, University Medical Center RotterdamAbstract Background The primary goal of hand hygiene is to reduce infectious disease rates. We examined if a nursing home’s participation in a hand hygiene intervention resulted in residents having fewer healthcare associated infections (HAIs) when compared to nursing homes without the hand hygiene intervention. Methods This study is a part of a cluster randomized controlled trial (RCT) in 33 nursing homes to improve hand hygiene (HANDSOME). The incidence of five illnesses was followed over 13 months: gastroenteritis, influenza-like illness, pneumonia, urinary tract infections and infections from methicillin-resistant Staphylococcus aureus (MRSA). Incidence rates per study arm were reported for baseline (October–December 2016) and two follow-up periods (January–April 2017, May–October 2017). HAI rates were compared in a Poisson multilevel analysis, correcting for baseline differences (the baseline infection incidence and the size of the nursing home), clustering of observations within nursing homes, and period in the study. Results There was statistically significantly more gastroenteritis (p < 0.001) and statistically significantly less influenza-like illness (p < 0.01) in the intervention arm when compared to the control arm. There were no statistically significant differences or pneumonia, urinary tract infections, and MRSA infections in the intervention arm when compared to the control arm. In a sensitivity analysis, gastroenteritis was no longer statistically significantly higher in the intervention arm (p = 0.92). Conclusions As in comparable studies, we could not conclusively demonstrate the effectiveness of an HH intervention in reducing HAIs among residents of nursing homes, despite the use of clearly defined outcome measures, a standardized reporting instrument, and directly observed HH in a multicenter cluster RCT. Trial registration Netherlands Trial Register, trial NL6049 (NTR6188). Registered October 25, 2016, https://www.trialregister.nl/trial/6049 .https://doi.org/10.1186/s13756-021-00946-3Healthcare associated infectionsNursing homesHand hygiene |
| spellingShingle | G. R. Teesing J. H. Richardus D. Nieboer M. Petrignani V. Erasmus A. Verduijn-Leenman J. M. G. A. Schols M. P. G. Koopmans M. C. Vos H. A. C. M. Voeten The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial Antimicrobial Resistance and Infection Control Healthcare associated infections Nursing homes Hand hygiene |
| title | The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial |
| title_full | The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial |
| title_fullStr | The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial |
| title_full_unstemmed | The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial |
| title_short | The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial |
| title_sort | effect of a hand hygiene intervention on infections in residents of nursing homes a cluster randomized controlled trial |
| topic | Healthcare associated infections Nursing homes Hand hygiene |
| url | https://doi.org/10.1186/s13756-021-00946-3 |
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