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SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit

Background: Hand hygiene (HH) is a cornerstone of programmes to prevent healthcare associated infections (HAI) globally, but HH interventions are seldom reported from African neonatal units. Methods: We conducted a quasi-experimental study evaluating the impact of a multi-modal intervention (SafeHAN...

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Autores principales: Dramowski, Angela, Erasmus, Louisa M., Aucamp, Marina, Fataar, Aaqilah, Cotton, Mark F., Coffin, Susan E., Bekker, Adrie, Whitelaw, Andrew C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867086/
https://www.ncbi.nlm.nih.gov/pubmed/36668933
http://dx.doi.org/10.3390/tropicalmed8010027
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author Dramowski, Angela
Erasmus, Louisa M.
Aucamp, Marina
Fataar, Aaqilah
Cotton, Mark F.
Coffin, Susan E.
Bekker, Adrie
Whitelaw, Andrew C.
author_facet Dramowski, Angela
Erasmus, Louisa M.
Aucamp, Marina
Fataar, Aaqilah
Cotton, Mark F.
Coffin, Susan E.
Bekker, Adrie
Whitelaw, Andrew C.
author_sort Dramowski, Angela
collection PubMed
description Background: Hand hygiene (HH) is a cornerstone of programmes to prevent healthcare associated infections (HAI) globally, but HH interventions are seldom reported from African neonatal units. Methods: We conducted a quasi-experimental study evaluating the impact of a multi-modal intervention (SafeHANDS) on HH compliance rates, alcohol-based handrub (ABHR) usage, the Hand Hygiene Self-Assessment Framework (HHSAF) score, and healthcare-associated bloodstream infection (HA-BSI) rates at a 132-bed South African neonatal unit (4 wards and 1 neonatal intensive care unit [NICU]). The intervention included a campaign logo, HH training, maternal education leaflets, ABHR bottles for staff, and the setting of HH performance targets with feedback. Three 5-month study phases were completed in July 2020 (baseline), December 2020 (early) and May 2021 (intensive). Results: A total of 2430 HH opportunities were observed: 1002 (41.3%) at baseline, 630 (25.9%) at early and 798 (32.8%) at intensive study phases. At baseline, the overall neonatal unit HH compliance rate was 61.6%, ABHR use was 70 mL/patient day, and the baseline HHSAF score was ‘basic’ (165). The overall neonatal unit HH compliance rate was unchanged from baseline to intensive phases (617/1002 [61.6%] vs. 497/798 [62.3%]; p = 0.797). The ABHR use remained similar between phases (70 versus 73 mL/patient day). The HHSAF score improved to ‘intermediate’ level (262). There was no change in the neonatal unit HA-BSI rate. Conclusion: Despite improvement in the HHSAF score, no improvement in overall HH compliance rates, ABHR usage, or HA-BSI rates was observed. Future HH interventions in resource-limited neonatal units should incorporate implementation science and behaviour modification strategies to better understand the barriers and facilitators of HH best practice.
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spelling pubmed-98670862023-01-22 SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit Dramowski, Angela Erasmus, Louisa M. Aucamp, Marina Fataar, Aaqilah Cotton, Mark F. Coffin, Susan E. Bekker, Adrie Whitelaw, Andrew C. Trop Med Infect Dis Article Background: Hand hygiene (HH) is a cornerstone of programmes to prevent healthcare associated infections (HAI) globally, but HH interventions are seldom reported from African neonatal units. Methods: We conducted a quasi-experimental study evaluating the impact of a multi-modal intervention (SafeHANDS) on HH compliance rates, alcohol-based handrub (ABHR) usage, the Hand Hygiene Self-Assessment Framework (HHSAF) score, and healthcare-associated bloodstream infection (HA-BSI) rates at a 132-bed South African neonatal unit (4 wards and 1 neonatal intensive care unit [NICU]). The intervention included a campaign logo, HH training, maternal education leaflets, ABHR bottles for staff, and the setting of HH performance targets with feedback. Three 5-month study phases were completed in July 2020 (baseline), December 2020 (early) and May 2021 (intensive). Results: A total of 2430 HH opportunities were observed: 1002 (41.3%) at baseline, 630 (25.9%) at early and 798 (32.8%) at intensive study phases. At baseline, the overall neonatal unit HH compliance rate was 61.6%, ABHR use was 70 mL/patient day, and the baseline HHSAF score was ‘basic’ (165). The overall neonatal unit HH compliance rate was unchanged from baseline to intensive phases (617/1002 [61.6%] vs. 497/798 [62.3%]; p = 0.797). The ABHR use remained similar between phases (70 versus 73 mL/patient day). The HHSAF score improved to ‘intermediate’ level (262). There was no change in the neonatal unit HA-BSI rate. Conclusion: Despite improvement in the HHSAF score, no improvement in overall HH compliance rates, ABHR usage, or HA-BSI rates was observed. Future HH interventions in resource-limited neonatal units should incorporate implementation science and behaviour modification strategies to better understand the barriers and facilitators of HH best practice. MDPI 2022-12-29 /pmc/articles/PMC9867086/ /pubmed/36668933 http://dx.doi.org/10.3390/tropicalmed8010027 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dramowski, Angela
Erasmus, Louisa M.
Aucamp, Marina
Fataar, Aaqilah
Cotton, Mark F.
Coffin, Susan E.
Bekker, Adrie
Whitelaw, Andrew C.
SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title_full SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title_fullStr SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title_full_unstemmed SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title_short SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit
title_sort safehands: a multimodal hand hygiene intervention in a resource-limited neonatal unit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867086/
https://www.ncbi.nlm.nih.gov/pubmed/36668933
http://dx.doi.org/10.3390/tropicalmed8010027
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