A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial

Autores
Rodriguez, Viviana; Giuffre, Carolina; Villa, Silvia; Almada, Griselda; Prasopa Plaizier, Nittita; Gogna, Monica Laura; Gibbons, Luz; Garcia Elorrio, Ezequiel; Argentinian Group Hand Hygiene Improvement
Año de publicación
2015
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Issue: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1–3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. Initial assessment: In order to estimate the effect of a multimodal intervention on improving healthcare workers’ compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. Choice of solution and implementation: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). Evaluation: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13–1.22). The effect was still present after adjustment by calendar’s time and providers’ characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03–1.14). Lessons learned: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.
Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Giuffre, Carolina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Villa, Silvia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Almada, Griselda. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Prasopa Plaizier, Nittita. Instituto de Efectividad Clínica y Sanitaria; Argentina. World Health Organization; Suiza
Fil: Gogna, Monica Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Argentinian Group Hand Hygiene Improvement. No especifica;
Materia
Hand Hygiene
Multimodal Intervention
Argentina
Infection Control
Who
Intensive Care Unit
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/42947
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/42947
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trialRodriguez, VivianaGiuffre, CarolinaVilla, SilviaAlmada, GriseldaPrasopa Plaizier, NittitaGogna, Monica LauraGibbons, LuzGarcia Elorrio, EzequielArgentinian Group Hand Hygiene ImprovementHand HygieneMultimodal InterventionArgentinaInfection ControlWhoIntensive Care Unithttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Issue: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1–3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. Initial assessment: In order to estimate the effect of a multimodal intervention on improving healthcare workers’ compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. Choice of solution and implementation: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). Evaluation: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13–1.22). The effect was still present after adjustment by calendar’s time and providers’ characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03–1.14). Lessons learned: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Giuffre, Carolina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Villa, Silvia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Almada, Griselda. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; ArgentinaFil: Prasopa Plaizier, Nittita. Instituto de Efectividad Clínica y Sanitaria; Argentina. World Health Organization; SuizaFil: Gogna, Monica Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Argentinian Group Hand Hygiene Improvement. No especifica;Oxford University Press2015-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/42947Rodriguez, Viviana; Giuffre, Carolina; Villa, Silvia; Almada, Griselda; Prasopa Plaizier, Nittita; et al.; A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial; Oxford University Press; International Journal For Quality In Health Care; 27; 5; 10-2015; 405-4111353-4505CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1093/intqhc/mzv065info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/intqhc/article/27/5/405/2357434info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:06:44Zoai:ri.conicet.gov.ar:11336/42947instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:06:44.692CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
title A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
spellingShingle A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
Rodriguez, Viviana
Hand Hygiene
Multimodal Intervention
Argentina
Infection Control
Who
Intensive Care Unit
title_short A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
title_full A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
title_fullStr A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
title_full_unstemmed A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
title_sort A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial
dc.creator.none.fl_str_mv Rodriguez, Viviana
Giuffre, Carolina
Villa, Silvia
Almada, Griselda
Prasopa Plaizier, Nittita
Gogna, Monica Laura
Gibbons, Luz
Garcia Elorrio, Ezequiel
Argentinian Group Hand Hygiene Improvement
author Rodriguez, Viviana
author_facet Rodriguez, Viviana
Giuffre, Carolina
Villa, Silvia
Almada, Griselda
Prasopa Plaizier, Nittita
Gogna, Monica Laura
Gibbons, Luz
Garcia Elorrio, Ezequiel
Argentinian Group Hand Hygiene Improvement
author_role author
author2 Giuffre, Carolina
Villa, Silvia
Almada, Griselda
Prasopa Plaizier, Nittita
Gogna, Monica Laura
Gibbons, Luz
Garcia Elorrio, Ezequiel
Argentinian Group Hand Hygiene Improvement
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hand Hygiene
Multimodal Intervention
Argentina
Infection Control
Who
Intensive Care Unit
topic Hand Hygiene
Multimodal Intervention
Argentina
Infection Control
Who
Intensive Care Unit
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Issue: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1–3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. Initial assessment: In order to estimate the effect of a multimodal intervention on improving healthcare workers’ compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. Choice of solution and implementation: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). Evaluation: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13–1.22). The effect was still present after adjustment by calendar’s time and providers’ characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03–1.14). Lessons learned: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.
Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Giuffre, Carolina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Villa, Silvia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Almada, Griselda. Instituto de Efectividad Clínica y Sanitaria; Argentina. Asociación Argentina de Enfermeros en Control de Infecciones; Argentina
Fil: Prasopa Plaizier, Nittita. Instituto de Efectividad Clínica y Sanitaria; Argentina. World Health Organization; Suiza
Fil: Gogna, Monica Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Argentinian Group Hand Hygiene Improvement. No especifica;
description Issue: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1–3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. Initial assessment: In order to estimate the effect of a multimodal intervention on improving healthcare workers’ compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. Choice of solution and implementation: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). Evaluation: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13–1.22). The effect was still present after adjustment by calendar’s time and providers’ characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03–1.14). Lessons learned: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.
publishDate 2015
dc.date.none.fl_str_mv 2015-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/42947
Rodriguez, Viviana; Giuffre, Carolina; Villa, Silvia; Almada, Griselda; Prasopa Plaizier, Nittita; et al.; A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial; Oxford University Press; International Journal For Quality In Health Care; 27; 5; 10-2015; 405-411
1353-4505
CONICET Digital
CONICET
url http://hdl.handle.net/11336/42947
identifier_str_mv Rodriguez, Viviana; Giuffre, Carolina; Villa, Silvia; Almada, Griselda; Prasopa Plaizier, Nittita; et al.; A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial; Oxford University Press; International Journal For Quality In Health Care; 27; 5; 10-2015; 405-411
1353-4505
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1093/intqhc/mzv065
info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/intqhc/article/27/5/405/2357434
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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