Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study
Abstract Background Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the “Prevention of Hospital Infections by...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13756-022-01148-1 |
| _version_ | 1797863530124279808 |
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| author | Tjallie van der Kooi Hugo Sax Hajo Grundmann Didier Pittet Sabine de Greeff Jaap van Dissel Lauren Clack Albert W. Wu Judith Davitt Sofia Kostourou Alison Maguinness Anna Michalik Viorica Nedelcu Márta Patyi Janja Perme Hajdinjak Milena Prosen David Tellez Éva Varga Fani Veini Mirosław Ziętkiewicz Walter Zingg the PROHIBIT consortium |
| author_facet | Tjallie van der Kooi Hugo Sax Hajo Grundmann Didier Pittet Sabine de Greeff Jaap van Dissel Lauren Clack Albert W. Wu Judith Davitt Sofia Kostourou Alison Maguinness Anna Michalik Viorica Nedelcu Márta Patyi Janja Perme Hajdinjak Milena Prosen David Tellez Éva Varga Fani Veini Mirosław Ziętkiewicz Walter Zingg the PROHIBIT consortium |
| author_sort | Tjallie van der Kooi |
| collection | DOAJ |
| description | Abstract Background Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the “Prevention of Hospital Infections by Intervention and Training” (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect. Methods We included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman’s rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns. Results In total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18–0.97], and their median HH increase (ρ = 0.79 [0.08–0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance. Conclusions Both the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs’ overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future. |
| first_indexed | 2024-04-09T22:36:58Z |
| format | Article |
| id | doaj.art-4384fb3084b2497187210e0003f380ae |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-04-09T22:36:58Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-4384fb3084b2497187210e0003f380ae2023-03-22T12:25:03ZengBMCAntimicrobial Resistance and Infection Control2047-29942022-10-011111910.1186/s13756-022-01148-1Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT studyTjallie van der Kooi0Hugo Sax1Hajo Grundmann2Didier Pittet3Sabine de Greeff4Jaap van Dissel5Lauren Clack6Albert W. Wu7Judith Davitt8Sofia Kostourou9Alison Maguinness10Anna Michalik11Viorica Nedelcu12Márta Patyi13Janja Perme Hajdinjak14Milena Prosen15David Tellez16Éva Varga17Fani Veini18Mirosław Ziętkiewicz19Walter Zingg20the PROHIBIT consortiumRIVM National Institute for Public Health and the EnvironmentDivision of Infectious Diseases and Hospital Epidemiology, University Hospital ZurichMedical Center – University of FreiburgUniversity of Geneva HospitalsRIVM National Institute for Public Health and the EnvironmentRIVM National Institute for Public Health and the EnvironmentDivision of Infectious Diseases and Hospital Epidemiology, University Hospital ZurichCenter for Health Services and Outcomes Research, Johns Hopkins University Bloomberg School of Public HealthGalway University HospitalEvangelismos HospitalSt. Michaels HospitalFaculty of Health Sciences, University of Bielsko-BialaEmergency Institute for Cardiovascular Diseases “Prof. C.C. Iliescu”Bács-Kiskun Megyei Kórház (County Teaching Hospital)University Medical Centre LjubljanaUniversity Medical Centre LjubljanaHospital Vall d’HebronBács-Kiskun Megyei Kórház (County Teaching Hospital)Evangelismos HospitalJohn Paul II HospitalDivision of Infectious Diseases and Hospital Epidemiology, University Hospital ZurichAbstract Background Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the “Prevention of Hospital Infections by Intervention and Training” (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect. Methods We included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman’s rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns. Results In total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18–0.97], and their median HH increase (ρ = 0.79 [0.08–0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance. Conclusions Both the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs’ overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future.https://doi.org/10.1186/s13756-022-01148-1Hand hygieneActivity indexIndividualInterventionIntensive careMulticentre |
| spellingShingle | Tjallie van der Kooi Hugo Sax Hajo Grundmann Didier Pittet Sabine de Greeff Jaap van Dissel Lauren Clack Albert W. Wu Judith Davitt Sofia Kostourou Alison Maguinness Anna Michalik Viorica Nedelcu Márta Patyi Janja Perme Hajdinjak Milena Prosen David Tellez Éva Varga Fani Veini Mirosław Ziętkiewicz Walter Zingg the PROHIBIT consortium Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study Antimicrobial Resistance and Infection Control Hand hygiene Activity index Individual Intervention Intensive care Multicentre |
| title | Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study |
| title_full | Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study |
| title_fullStr | Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study |
| title_full_unstemmed | Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study |
| title_short | Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study |
| title_sort | hand hygiene improvement of individual healthcare workers results of the multicentre prohibit study |
| topic | Hand hygiene Activity index Individual Intervention Intensive care Multicentre |
| url | https://doi.org/10.1186/s13756-022-01148-1 |
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