• Victor D Rosenthal, Mandakini Pawar, Hakan Leblebicioglu, Josephine Anne Navoa-Ng, Wilmer Villamil-Gómez, Alberto Armas-Ruiz, Luis E Cuéllar, Eduardo A Medeiros, Zan Mitrev, Achilleas Gikas, Yun Yang, Altaf Ahmed, Souha S Kanj, Lourdes Dueñas, Vaidotas Gurskis, Trudell Mapp, Humberto Guanche-Garcell, Rosalía Fernández-Hidalgo, and Andrzej Kübler.
• International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
• Infect Control Hosp Epidemiol. 2013 Apr 1; 34 (4): 415-23.

ObjectiveTo assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.DesignAn observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.SettingNinety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.ParticipantsHealthcare workers at 99 ICU members of the INICC.MethodsA multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.ResultsA total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% ([Formula: see text]). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; [Formula: see text]), physicians versus nurses (62% vs 72%; [Formula: see text]), and adult versus neonatal ICUs (67% vs 81%; [Formula: see text]), among others.ConclusionsAdherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented.

39 keywords...

hide…