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Paediatrics
Research
An observational study of the hand hygiene initiative: a comparison of preintervention and postintervention outcomes
  1. Amit Mukerji1,
  2. Janet Narciso2,
  3. Christine Moore3,
  4. Allison McGeer4,
  5. Edmond Kelly1,
  6. Vibhuti Shah1
  1. 1Department of Paediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Nursing, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
  3. 3Department of Infection Control, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
  4. 4Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Vibhuti Shah; vshah{at}mtsinai.on.ca

Abstract

Objectives To evaluate the impact of implementing a simple, user-friendly eLearning module on hand hygiene (HH) compliance and infection rates.

Design Preintervention and postintervention observational study.

Participants All neonates admitted to the neonatal intensive care unit (NICU) over the study period were eligible for participation and were included in the analyses. A total of 3422 patients were admitted over a 36-month span (July 2009 to June 2012).

Interventions In the preintervention and postintervention periods (phases I and II), all healthcare providers were trained on HH practices using an eLearning module. The principles of the ‘4 moments of HH’ and definition of ‘baby space’ were incorporated using interactive tools. The intervention then extended into a long-term sustainability programme (phase III), including the requirement of an annual recertification of the module and introduction of posters and screensavers throughout the NICU.

Primary and secondary outcome measures The primary outcome was HH compliance rates among healthcare providers in the three phases. The secondary outcome was healthcare-associated infection rates in the NICU.

Results HH compliance rates declined initially in phase II then improved in phase III with the addition of a long-term sustainability programme (76%, 67% and 76% in phases I, II and III, respectively (p<0.01). Infection rates showed an opposing, but concomitant trend in the overall population as well as in infants <1500 g and were 4%, 6% and 4% (p=0.02), and 11%, 21% and 16% (p<0.01), respectively, during the three phases.

Conclusions Interventions to improve HH compliance are challenging to implement and sustain with the need for ongoing reinforcement and education.

  • Healthcare-associated infection
  • Nosocomial infection
  • Baby space
  • Hand hygiene compliance

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

https://doi.org/10.1136/bmjopen-2013-003018

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