Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel

被引：43

作者：

Aboumatar, Hanan ^{[1
,2
]}

Ristaino, Polly ^{[3
,4
]}

Davis, Richard O. ^{[2
]}

Thompson, Carol B. ^{[5
]}

Maragakis, Lisa ^{[3
,4
]}

Cosgrove, Sara ^{[3
,4
]}

Rosenstein, Beryl ^{[6
]}

Perl, Trish M. ^{[3
,4
]}

机构：

[1] Johns Hopkins Univ, Dept Med, Div Gen Internal Med, Baltimore, MD 21287 USA

[2] Ctr Innovat Qual Patient Care, Baltimore, MD USA

[3] Johns Hopkins Univ, Dept Med, Div Infect Dis, Baltimore, MD 21287 USA

[4] Johns Hopkins Univ Hosp, Dept Hosp Epidemiol & Infect Control, Baltimore, MD 21287 USA

[5] Johns Hopkins Univ, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD 21287 USA

[6] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21287 USA

来源：

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY | 2012年 / 33卷 / 02期

关键词：

RESISTANT STAPHYLOCOCCUS-AUREUS; NOSOCOMIAL INFECTIONS; ACQUISITION;

D O I：

10.1086/663707

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BACKGROUND. Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor. OBJECTIVE. To assess short-and long-term effects of an infection prevention promotion program on healthcare personnel hand hygiene behaviors. DESIGN. Time series design. SETTING Our study was conducted at a tertiary care academic center. PARTICIPANTS. Hospital healthcare personnel. METHODS. We developed a multimodal program that included a multimedia communications campaign, education, leadership engagement, environment modification, team performance measurement, and feedback. Healthcare personnel hand hygiene practices were measured via direct observations over a 3-year period by "undercover" observers. RESULTS. Overall hand hygiene compliance increased by 2-fold after full program implementation (P < .001), and this increase was sustained over a 20-month follow-up period (P < .001). The odds for compliance with hand hygiene increased by 3.8-fold in the 6 months after full program implementation (95% confidence interval, 3.53-4.23; P < .001), and this increase was sustained. There was even a modest increase at 20 months of follow up. Hand hygiene compliance increased among all disciplines and hospital units. Hand hygiene compliance increased from 35% in the first 6 months after program initiation to 77% in the last 6 months of the study period among nursing providers (P < .001), from 38% to 62% among medical providers (P < .001), and from 27% to 75% among environmental services staff (P < .001). CONCLUSIONS. Implementation of the infection prevention promotion program was associated with a significant and sustained increase in hand hygiene practices among healthcare personnel of various disciplines. Infect Control Hosp Epidemiol 2012;33(2):144-151

引用

页码：144 / 151

页数：8

共 18 条

[1] Effectiveness of a hand hygiene promotion strategy using alcohol-based handrub in 6 intensive care units in Colombia [J].

Barrera, Lena ;

Zingg, Walter ;

Mendez, Fabian ;

Pittet, Didier .

AMERICAN JOURNAL OF INFECTION CONTROL, 2011, 39 (08) :633-639

[2] Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients [J].

Bhalla, A ;

Pultz, NJ ;

Gries, DM ;

Ray, AJ ;

Eckstein, EC ;

Aron, DC ;

Donskey, CJ .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2004, 25 (02) :164-167

[3] Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force [J].

Boyce, JM ;

Pittet, D .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2002, 23 (12) :S3-S40

[4] COMPARATIVE EFFICACY OF ALTERNATIVE HAND-WASHING AGENTS IN REDUCING NOSOCOMIAL INFECTIONS IN INTENSIVE-CARE UNITS [J].

DOEBBELING, BN ;

STANLEY, GL ;

SHEETZ, CT ;

PFALLER, MA ;

HOUSTON, AK ;

ANNIS, L ;

LI, N ;

WENZEL, RP .

NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (02) :88-93

[5]

Green L W, 1991, Journ Annu Diabetol Hotel Dieu, P227

[6]

Green LW., 1999, Health Promotion Planning: An Educational and Ecological Approach, V3rd ed.

[7] Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat [J].

Grundmann, Hajo ;

Aires-de-Sousa, Marta ;

Boyce, John ;

Tiemersma, Edine .

LANCET, 2006, 368 (9538) :874-885

[8] Study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients' acquisition of MRSA [J].

Hardy, Katherine J. ;

Oppenheim, Beryl A. ;

Gossain, Savita ;

Gao, Fang ;

Hawkey, Peter M. .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2006, 27 (02) :127-132

[9] Meta-Analysis Audit and Feedback Features Impact Effectiveness on Care Quality [J].

Hysong, Sylvia J. .

MEDICAL CARE, 2009, 47 (03) :356-363

[10] Estimating health care-associated infections and deaths in US hospitals, 2002 [J].

Klevens, R. Monina ;

Edwards, Jonathan R. ;

Richards, Chesley L., Jr. ;

Horan, Teresa C. ;

Gaynes, Robert P. ;

Pollock, Daniel A. ;

Cardo, Denise M. .

PUBLIC HEALTH REPORTS, 2007, 122 (02) :160-166

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