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Long-term effectiveness evaluation of an action-research intervention to improve hand hygiene in an intensive care unit
Affiliation:1. Medical Management Department, Hospital “Cà Foncello”, Azienda ULSS n.2 “Marca Trevigiana”, Regione Veneto, Via Sant'' Ambrogio di Fiera, 37 – 31100, Treviso, Italy;2. Department of Anesthesia and Intensive Care, Azienda ULSS n.2 “Marca Trevigiana”, Regione Veneto, Via Sant'' Ambrogio di Fiera, 37 – 31100, Treviso, Italy;3. Health Education and Research Consultant, Association “Marketing Sociale e Comunicazione per la Salute (Social Marketing and Communication for Health)”, Modena, Italy;1. Critical Care Complex, Middlemore Hospital, Auckland, New Zealand;2. School of Nursing, Massey University, Auckland, New Zealand;1. Intensive Care Unit, Consorci Hospitalari de Vic (CHV), Vic, Spain;2. University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain;1. Centre for Care Excellence, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom;2. Therapies, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom;1. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium;2. Nursing and Paramedical Department, AZ Nikolaas (General Hospital), Moerlandstraat 1, 9100 Sint-Niklaas, Belgium;3. Emergency Department, AZ Nikolaas (General Hospital), Moerlandstraat 1, 9100 Sint-Niklaas, Belgium;4. Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium;5. Burns, Trauma, and Critical Care Research Centre, Faculty of Medicine, The University of Queensland, Australia;6. Executive Board of the Flemish Society for Critical Care Nurses, Ghent, Belgium;7. Emergency Department, St. Lucas General Hospital, Groenebriel 1, 9000 Ghent, Belgium;8. Department of Fundamental and Applied Medical Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium;1. Groupe Hospitalier Pitié-Salpêtrière, AP-HP Sorbonne-Université, France;1. Faculty of Nursing, Chiang Mai University, Chiangmai, Thailand;2. Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand;3. Nakornping Hospital, Donkaew Sub-district, Mae Rim, Chiangmai, Thailand;4. Infectious Diseases Research Unit (IDRU), Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
Abstract:ObjectivesTo evaluate the long-term effectiveness of an action research intervention aimed at improving hand hygiene in an intensive care unit of a public hospital in Italy.MethodsAn observational, prospective before-after study was carried out. Compliance with hand hygiene was estimated by measuring the utilization of hand hygiene products before the intervention and four years after the end of the project. Products used were the following: detergent liquid soap, antiseptic liquid soap and alcohol-based hand gel. Endpoints were quantity consumed (in grams) for each product category. Quantitative consumptions per workshift were compared.ResultsIn 2017 the median consumption of antiseptic liquid soap and alcohol-based hand gel per workshift was significantly higher than in 2012 (111.5 g vs 72.5 g, p = 0.014, and 18.0 g vs 5.0 g, p < 0.001). Odds in favour of a higher value in 2017 were 1.99:1 (CI95%: 1.19:1 to 3.73:1) for antiseptic solution, and 5.39:1 (CI95%: 3.09:1 to 13.61:1) for antiseptic gel. Covariates were not associated with consumption of products, and this made it possible to compare the measurements in the two data collections.ConclusionsResults of this study support the long-term effectiveness of the action research intervention to improve practices of hand hygiene in an intensive care setting.
Keywords:Action research  Effectiveness  Evaluation  Hand hygiene  Intensive care unit  Organisational change
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