Methods: This a prospective interventional study conducted at Makassed General hospital, Beirut Lebanon, during 21 weeks from November 2015-March 2016. We compared two interventional methods for implementing compliance to the ‘WHO 5 moments for HH’ among 89 nurses. There were 3 groups: control, incentive-driven, and audit/feedback. The intervention was from week-1 to week-14. From week-15 to week-21 was an observational phase where we studied the sustainability of HH behavior.
The baseline HH compliance rate (HHCR) was 16% in the control group, 21% in the incentive-driven group, and 23% in the feedback group. During the whole study, the HHCR did not change in the control group. The incentive-based group showed significant increase in the HHCR compared to baseline peaking at 77% by week-14. (P<0.0001) The audit/feedback group also showed progress yet to a lesser extent than the incentive-based group; HHCR peaked at 51% during week-14. (P<0.0001) After stopping the interventions, the HHCR in the incentive-based group dropped to 34% by week-21 unlike the audit/feedback group, which achieved a steady state in HHCR till the end. (P<0.0001) Sustainability in HHCR in the audit/feedback group was significantly higher than that of incentive-based group. (P<0.0001) Upon analyzing each of the 5 moments of HH separately, we realized that participants were mostly complaint to Moments 4 and 3. They were least compliant to Moment 2.
Compliance to the 5 moments for HH was not achieved by default. The incentive-driven intervention helped boost the HH compliance and Feedback/Audit intervention helped maintain it.
R. Soboh, None
A. Abyad, None
M. Al-Helou, None