Improving healthcare worker hand hygiene adherence before patient contact: A contest between three Japanese tertiary care centers
Methods: Hand hygiene adherence was re-evaluated in three to four wards in each hospital - a surgical unit, a medical unit, an intensive care unit, and/or an emergency department – after a 6-month hand hygiene intervention. While all hospitals were provided guidance about the World Health Organization (WHO) multimodal hand-hygiene intervention, each hospital could tailor the intervention to their facility. Post-intervention hand hygiene adherence rates for each unit and hospital were compared to pre-intervention rates. Using the same methods as for pre-intervention, we focused on hand hygiene before patient contact. The hospital that achieved the highest hand hygiene adherence after the intervention was offered a prize consisting of 500,000 Japanese yen (approximately 5,000 USD) and a trophy, provided by an American collaborator not affiliated with any of the Japanese hospitals.
Results: A total of 2,982 post intervention provider-patient encounters were observed in 10 units across the three participating hospitals. Overall, the post-intervention hand hygiene adherence rate was significantly improved (18% pre- to 33% post-intervention; P<.001). Hand hygiene adherence was improved for both nurses (21% to 35%; P <.001) and physicians (15% to 30%; P <.001) post-intervention. Among those with appropriate hand hygiene, the use of alcohol-based hand rub increased significantly (67% pre- to 90% post-intervention; P<.001). The improvement in adherence rates varied considerably, however, by hospital (Hospital A +29%, Hospital B +5%, Hospital C +7%). Hospital A was the contest winner with 40% adherence post-intervention.
Conclusion: Use of a contest during implementation of a WHO-based multimodal intervention was successful in improving healthcare worker hand hygiene adherence rates in three hospitals in Japan. However, more work is required to improve hand hygiene compliance as rates remain low.
S. Saint, None
K. Fowler, None
T. Kamiya, None
Y. Sato, None
R. Iuchi, None
Y. Tokuda, None