Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel.
Infect Control Hosp Epidemiol. 2012 Feb;33(2):144-51
Authors: Aboumatar H, Ristaino P, Davis RO, Thompson CB, Maragakis L, Cosgrove S, Rosenstein B, Perl TM
Abstract
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 ([Formula: see text]), and this increase was sustained over a 20-month follow-up period ([Formula: see text]). 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; [Formula: see text]), 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 ([Formula: see text]), from 38% to 62% among medical providers ([Formula: see text]), and from 27% to 75% among environmental services staff ([Formula: see text]). 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.
PMID: 22227983 [PubMed - in process]