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Article: Hand hygiene practices in a neonatal intensive care unit: A multimodal intervention and impact on nosocomial infection

TitleHand hygiene practices in a neonatal intensive care unit: A multimodal intervention and impact on nosocomial infection
Authors
KeywordsEducation
Hand hygiene
Neonatal intensive care
Issue Date2004
PublisherAmerican Academy of Pediatrics. The Journal's web site is located at http://pediatrics.aappublications.org/
Citation
Pediatrics, 2004, v. 114 n. 5, p. e565-e571 How to Cite?
AbstractObjective. Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. Methods. The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. Results. Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. Conclusion. A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance. Copyright © 2004 by the American Academy of Pediatrics.
Persistent Identifierhttp://hdl.handle.net/10722/80040
ISSN
2015 Impact Factor: 5.196
2015 SCImago Journal Rankings: 3.226
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, BCCen_HK
dc.contributor.authorLee, Jen_HK
dc.contributor.authorLau, YLen_HK
dc.date.accessioned2010-09-06T08:01:41Z-
dc.date.available2010-09-06T08:01:41Z-
dc.date.issued2004en_HK
dc.identifier.citationPediatrics, 2004, v. 114 n. 5, p. e565-e571en_HK
dc.identifier.issn0031-4005en_HK
dc.identifier.urihttp://hdl.handle.net/10722/80040-
dc.description.abstractObjective. Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. Methods. The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. Results. Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. Conclusion. A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance. Copyright © 2004 by the American Academy of Pediatrics.en_HK
dc.languageengen_HK
dc.publisherAmerican Academy of Pediatrics. The Journal's web site is located at http://pediatrics.aappublications.org/en_HK
dc.relation.ispartofPediatricsen_HK
dc.subjectEducationen_HK
dc.subjectHand hygieneen_HK
dc.subjectNeonatal intensive careen_HK
dc.titleHand hygiene practices in a neonatal intensive care unit: A multimodal intervention and impact on nosocomial infectionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1120-7507&volume=114&spage=565&epage=571&date=2004&atitle=Hand+Hygiene+Practices+in+a+Neonatal+Intensive+Care+Unit:+A+Multimodal+Intervention+and+Impact+on+Nosocomial+Infectionen_HK
dc.identifier.emailLau, YL:lauylung@hkucc.hku.hken_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1542/peds.2004-1107en_HK
dc.identifier.pmid15492360-
dc.identifier.scopuseid_2-s2.0-16644389232en_HK
dc.identifier.hkuros96411en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-16644389232&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume114en_HK
dc.identifier.issue5en_HK
dc.identifier.spagee565en_HK
dc.identifier.epagee571en_HK
dc.identifier.isiWOS:000224842700053-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLam, BCC=8553938300en_HK
dc.identifier.scopusauthoridLee, J=9269060400en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK

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