• C Fariñas-Alvarez, T Portal-María, V Flor-Morales, A Aja-Herrero, M Fabo-Navarro, S Lanza-Marín, R Lobeira-Rubio, N Polo-Hernández, M Sixto-Montero, R Moreta-Sánchez, M Á Ballesteros-Sanz, L Yañez-San Segundo, M J Bartalome-Pacheco, and C Armiñanzas-Castillo.
• Grupo de Mejora de la Higiene de Manos, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: cfarinas@humv.es.
• Rev Calid Asist. 2017 Jan 1; 32 (1): 50-56.

ObjectiveWithin the framework of the PaSQ (Patient Safety and Quality care) Project, this hospital decided to implement a multifaceted hospital-wide Hand Hygiene (HH) intervention based on a multimodal WHO approach over one year, focusing on achieving a sustained change in HH cultural change in this hospital.Material And MethodsSetting: University Hospital Marqués de Valdecilla, Santander (Spain), a tertiary hospital with 900 beds. Intervention period: 2014. An action plan was developed that included the implementation of activities in each component of the 5-step multimodal intervention. An observation/feedback methodology was used that included the provision of performance and results feedback to the staff. A 3/3 strategy (non-blinded direct observation audits performed during 3 randomised days every 3 weeks with pro-active corrective actions at the end of each observation period). HH compliance, alcohol-based hand-rub (ABHR) consumption, and rate of MRSA infection, were monitored during the intervention.ResultsHospital ABHR consumption increased during the study period: from 17.5 to 19.7mL/patient-days. In the intervention units, this consumption was 24.8mL pre-intervention, 42.5mL during the intervention, and 30.4mL two months post-intervention. There were 137 evaluation periods in 30 different days, in which a total of 737 health-care workers were observed and 1,870 HH opportunities. HH compliance was 54.5%, ranging between 44.8% and 69.9%. The incidence of MRSA infection decreased during the intervention in the selected units, from 13.2 infections per 10,000 patient-days pre-intervention to 5.7 three months post-intervention.ConclusionsOur HH strategy, supported by a 3/3 strategy increased alcohol-based hand-rub consumption and compliance. A reduction in MRSA infections was observed.Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

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