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Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital

BACKGROUND: Standard hygiene precautions are an effective way of controlling healthcare-associated infections. Nevertheless, compliance with hand hygiene (HH) guidelines among healthcare workers (HCWs) is often poor, and evidence regarding appropriate use of gloves and gowns is limited and not encou...

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Autores principales: Baccolini, Valentina, D’Egidio, Valeria, de Soccio, Pasquale, Migliara, Giuseppe, Massimi, Azzurra, Alessandri, Francesco, Tellan, Guglielmo, Marzuillo, Carolina, De Vito, Corrado, Ranieri, Marco Vito, Villari, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544958/
https://www.ncbi.nlm.nih.gov/pubmed/31164981
http://dx.doi.org/10.1186/s13756-019-0544-0
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author Baccolini, Valentina
D’Egidio, Valeria
de Soccio, Pasquale
Migliara, Giuseppe
Massimi, Azzurra
Alessandri, Francesco
Tellan, Guglielmo
Marzuillo, Carolina
De Vito, Corrado
Ranieri, Marco Vito
Villari, Paolo
author_facet Baccolini, Valentina
D’Egidio, Valeria
de Soccio, Pasquale
Migliara, Giuseppe
Massimi, Azzurra
Alessandri, Francesco
Tellan, Guglielmo
Marzuillo, Carolina
De Vito, Corrado
Ranieri, Marco Vito
Villari, Paolo
author_sort Baccolini, Valentina
collection PubMed
description BACKGROUND: Standard hygiene precautions are an effective way of controlling healthcare-associated infections. Nevertheless, compliance with hand hygiene (HH) guidelines among healthcare workers (HCWs) is often poor, and evidence regarding appropriate use of gloves and gowns is limited and not encouraging. In this study, we evaluated the ability over time of a multimodal intervention to improve HCWs compliance with standard hygiene precautions. METHODS: Trend analysis of direct observations of compliance with HH guidelines and proper glove or gown use was conducted in the medical/surgical intensive care unit (ICU) of Umberto I Teaching Hospital of Sapienza University of Rome. The study consisted of two phases: a six-month baseline phase and a 12-month post-intervention phase. The multimodal intervention was based on the World Health Organization strategy and included education and training of HCWs, together with performance feedback. RESULTS: A total of 12,853 observations were collected from November 2016 to April 2018. Overall compliance significantly improved from 41.9% at baseline to 62.1% (p < 0.001) after the intervention and this improvement was sustained over the following trimesters. Despite variability across job categories and over the study period, a similar trend was observed for most investigations. The main determinants of compliance were job category (with nurses having the highest compliance rates), being a member of ICU staff and whether delivering routine, as opposed to emergency, care. HH compliance was modified by glove use; unnecessary gloving negatively affected HH behaviour while appropriate gloving positively influenced it. CONCLUSIONS: The multimodal intervention resulted in a significant improvement in compliance with standard hygiene precautions. However, regular educational reinforcement and feedback is essential to maintain a high and uniform level of compliance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13756-019-0544-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-65449582019-06-04 Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital Baccolini, Valentina D’Egidio, Valeria de Soccio, Pasquale Migliara, Giuseppe Massimi, Azzurra Alessandri, Francesco Tellan, Guglielmo Marzuillo, Carolina De Vito, Corrado Ranieri, Marco Vito Villari, Paolo Antimicrob Resist Infect Control Research BACKGROUND: Standard hygiene precautions are an effective way of controlling healthcare-associated infections. Nevertheless, compliance with hand hygiene (HH) guidelines among healthcare workers (HCWs) is often poor, and evidence regarding appropriate use of gloves and gowns is limited and not encouraging. In this study, we evaluated the ability over time of a multimodal intervention to improve HCWs compliance with standard hygiene precautions. METHODS: Trend analysis of direct observations of compliance with HH guidelines and proper glove or gown use was conducted in the medical/surgical intensive care unit (ICU) of Umberto I Teaching Hospital of Sapienza University of Rome. The study consisted of two phases: a six-month baseline phase and a 12-month post-intervention phase. The multimodal intervention was based on the World Health Organization strategy and included education and training of HCWs, together with performance feedback. RESULTS: A total of 12,853 observations were collected from November 2016 to April 2018. Overall compliance significantly improved from 41.9% at baseline to 62.1% (p < 0.001) after the intervention and this improvement was sustained over the following trimesters. Despite variability across job categories and over the study period, a similar trend was observed for most investigations. The main determinants of compliance were job category (with nurses having the highest compliance rates), being a member of ICU staff and whether delivering routine, as opposed to emergency, care. HH compliance was modified by glove use; unnecessary gloving negatively affected HH behaviour while appropriate gloving positively influenced it. CONCLUSIONS: The multimodal intervention resulted in a significant improvement in compliance with standard hygiene precautions. However, regular educational reinforcement and feedback is essential to maintain a high and uniform level of compliance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13756-019-0544-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-31 /pmc/articles/PMC6544958/ /pubmed/31164981 http://dx.doi.org/10.1186/s13756-019-0544-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Baccolini, Valentina
D’Egidio, Valeria
de Soccio, Pasquale
Migliara, Giuseppe
Massimi, Azzurra
Alessandri, Francesco
Tellan, Guglielmo
Marzuillo, Carolina
De Vito, Corrado
Ranieri, Marco Vito
Villari, Paolo
Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title_full Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title_fullStr Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title_full_unstemmed Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title_short Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
title_sort effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544958/
https://www.ncbi.nlm.nih.gov/pubmed/31164981
http://dx.doi.org/10.1186/s13756-019-0544-0
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