Interventions to improve hand hygiene compliance in patient care

被引:45
作者
Gould, D. J. [1 ]
Chudleigh, J. H. [1 ]
Moralejo, D. [1 ]
Drey, N. [1 ]
机构
[1] City Univ London, Sch Nursing & Midwifery, London EC1 4TY, England
来源
COCHRANE DATABASE OF SYSTEMATIC REVIEWS | 2007年 / 02期
关键词
D O I
10.1002/14651858.CD005186.pub2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. Objectives To assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. Search strategy We conducted electronic searches of. the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; Pubmed; EMBASE; CINAHL; and the BNI. All databases were searched to July 2006; MEDLINE was searched from 1980, CINAHL from its inception, and the remainder from 1990 until July 2006. Selection criteria Randomised controlled trials; controlled clinical trials; controlled before and after studies; and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group. Studies reporting proxy indicators of hand hygiene compliance were considered. Studies to promote compliance with universal precautions were included providing data relating specifically to hand hygiene were presented separately. Data collection and analysis Two reviewers independently extracted data and assessed data quality. Main results Two studies met the criteria for review. One was a randomised controlled trial. The other was a controlled before and after study. Both were poorly controlled. Statistically significant post-intervention increase in hand washing was reported in one study up to four months after the intervention. In the other there was no post-intervention increase in hand hygiene compliance. Authors' conclusions There is little robust evidence to inform the choice of interventions to improve hand hygiene. It appears that single interventions based on short, 'one off' teaching sessions are unlikely to be successful, even short-term. There is a need to undertake methodologically robust research to explore the effectiveness of soundly designed interventions to increase hand hygiene compliance.
引用
收藏
页数:17
相关论文
共 61 条
[1]  
[Anonymous], 2006, Cochrane Database of Syst Rev, DOI DOI 10.1002/14651858.CD000259.PUB2
[2]  
Avila-Aguero M L, 1998, Clin Perform Qual Health Care, V6, P70
[3]  
Baker DJ, 1998, MENT RETARD, V36, P198, DOI 10.1352/0047-6765(1998)036<0198:EOVSTW>2.0.CO
[4]  
2
[5]   CONTROL OF NOSOCOMIAL INFECTIONS IN AN INTENSIVE-CARE UNIT IN GUATEMALA-CITY [J].
BERG, DE ;
HERSHOW, RC ;
RAMIREZ, CA ;
WEINSTEIN, RA .
CLINICAL INFECTIOUS DISEASES, 1995, 21 (03) :588-593
[6]   Handwashing compliance by health care workers -: The impact of introducing an accessible, alcohol-based hand antiseptic [J].
Bischoff, WE ;
Reynolds, TM ;
Sessler, CN ;
Edmond, MB ;
Wenzel, RP .
ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (07) :1017-1021
[7]   Limited impact of sustained simple feedback based on soap and paper towel consumption on the frequency of hand washing in an adult intensive care unit [J].
Bittner, MJ ;
Rich, EC ;
Turner, PD ;
Arnold, WH .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2002, 23 (03) :120-126
[8]   Use of alcohol-based hand rub and quality improvement interventions to improve hand hygiene in a Russian neonatal intensive care unit [J].
Brown, SM ;
Lubimova, AV ;
Khrustalyeva, NM ;
Shulaeva, SV ;
Tekhova, I ;
Zueva, LP ;
Goldmann, D ;
O'Rourke, EJ .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2003, 24 (03) :172-179
[9]  
Coignard B, 1998, INFECT CONT HOSP EP, V19, P510
[10]   Impact of teaching interventions on nurse compliance with hand disinfection [J].
Colombo, C ;
Giger, H ;
Grote, J ;
Deplazes, C ;
Pletscher, W ;
Lüthi, R ;
Ruef, C .
JOURNAL OF HOSPITAL INFECTION, 2002, 51 (01) :69-72