The evaluation of a multimodal hand hygiene improvement strategy in Cambodian hospitals

Introduction: Hand hygiene is the most effective method of preventing healthcare-associated infections. Healthcare-associated infections are considered serious in developing countries, and there are few reports on the hand-hygiene status of these countries. Thus, we evaluated hand-hygiene status in eight hospitals in Cambodia to understand and identify factors hindering effective infection control. Methodology: Eight infection-management instructors working in one of the eight Cambodian government hospitals in a large city were interviewed with the WHO Hand Hygiene Self-Assessment Framework. Results: The mean Hand Hygiene Self-Assessment Framework score across the eight hospitals was 177.81 +/- 56.73. The overall level of compliance with the multimodal hand hygiene improvement strategy across these eight hospitals was basic-two hospitals scored inadequate and six hospitals scored basic. The scores for the 5 factors of the Hand Hygiene Self-Assessment Framework were as follows: 45.63 +/- 15.45 for system change, 33.13 +/- 16.89 for education and training, 27.81 +/- 21.65 for evaluation and feedback, 58.13 +/- 5.30 for reminders in the workplace, and 13.13 +/- 11.00 for institutional safety climate for hand hygiene Conclusions: The promotion of hand hygiene compliance requires the establishment of a basic infrastructure, reinforcement of the hand hygiene education system, and provision of diverse educational materials, as well as the fostering of a professional workforce for education. Hospitals should also bolster their management systems for hand hygiene compliance.