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Factors Associated with Hand Hygiene Compliance at a Tertiary Care Teaching Hospital

Part of: BARRY FARR AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Benjamin Kowitt ,
Julie Jefferson  and
Leonard A. Mermel
Benjamin Kowitt
Affiliation:
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Julie Jefferson
Affiliation:
Department of Epidemiology and Infection Control, Rhode Island Hospital, Providence, Rhode Island Program in Public Health, Brown University, Providence, Rhode Island
Leonard A. Mermel*
Affiliation:
Department of Epidemiology and Infection Control, Rhode Island Hospital, Providence, Rhode Island Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
*
Division of Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (lmermel@lifespan.org)
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Abstract

Objective.

To identify factors associated with hand hygiene compliance during a multiyear period of intervention.

Design.

Observational study.

Setting.

A 719-bed tertiary care teaching hospital.

Participants.

Nursing, physician, technical, and support staff.

Methods.

Light-duty staff performed hand hygiene observations during the period July 2008-December 2012. Infection control implemented hospital-wide hand hygiene initiatives, including education modules; posters and table tents; feedback to units, medical directors and the executive board; and an increased number of automated alcohol hand hygiene product dispensers.

Results.

There were 161,526 unique observations; overall compliance was 83%. Significant differences in compliance were observed between physician staff (78%) and support staff (69%) compared with nursing staff (84%). Pediatric units (84%) and intensive care units (84%) had higher compliance than did medical (82%) and surgical units (81%). These findings persisted in the controlled multivariate model for noncompliance. Additional factors found to be significant in the model included greater compliance when healthcare workers were leaving patient rooms, when the patient was under contact precautions, and during the evening shift. The overall rate of compliance increased from 60% in the first year of observation to a peak of 96% in the fourth year, and it decreased to 89% in the final year, with significant improvements occurring in each of the 4 professional categories.

Conclusions.

A multipronged hand hygiene initiative is effective in increasing compliance rates among all categories of hospital workers. We identified a variety of factors associated with increased compliance. Additionally, we note the importance of continuous interventions in maintaining high compliance rates.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 11 , November 2013 , pp. 1146 - 1152
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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