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October 8, 2013

Hand hygiene programs: What really works?

Daily Briefing

Feedback, educational programs, and reminders can help improve hand hygiene compliance among hospital staff—but data on which interventions are most effective remain limited, according to University of Iowa (UI) researchers.

The researchers presented their findings at the IDWeek 2013 national meeting this week. They reviewed studies conducted between 2000 and 2010 that assessed efforts to improve hand hygiene compliance. The data pool included six randomized trials and 39 quasi-experimental studies.

Hand hygiene programs: the simpler the better

The studies evaluating "bundled interventions"—which consisted of education, reminders, feedback, administrative support, and access to alcohol-based hand rub—found an improvement in hygiene compliance. Additionally, a "bundle" that included education, reminders, and feedback in NICUs was associated with improved hygiene compliance.

According to lead author Marin Schweizer, the most promising hand-washing interventions came from the World Health Organization (WHO) and Veterans Health Affairs (VA). The guidelines—which stress feedback, education, and reminders—had nearly twofold odds of increasing hand-washing compliance.

Hospitals try to boost hygiene
Gold stars and 'red cards'
Pop quizzes and white boards
Monitoring technology
Pushing patients to ask

However, bundled interventions that included a large number of components did not boost hand-washing compliance, the researchers noted. They suggested that two components per intervention was the optimal number to ensure employee compliance.

"Before expanding current bundles, individual bundle components should be evaluated via clinical trials," the authors wrote. However, Schweizer cautioned that the majority of studies included in the latest meta-analysis were methodologically flawed. She called for higher quality studies assessing hand hygiene in health care settings (Petrochko, MedPage Today, 10/7).

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