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Cluster Randomized Trial to Evaluate the Effect of a Multimodal Hand Hygiene Improvement Strategy in Primary Care

Published online by Cambridge University Press:  02 January 2015

Carmen Martín-Madrazo ,
Sonia Soto-Díaz ,
Asuncion Cañada-Dorado ,
Miguel Angel Salinero-Fort ,
Manuela Medina-Fernández ,
Enrique Carrillo de Santa Pau ,
Paloma Gómez-Campelo  and
Juan Carlos Abánades-Herranz
Carmen Martín-Madrazo*
Affiliation:
Centro de Salud Monóvar, Gerencia de Atención Primaria de Madrid, Spain
Sonia Soto-Díaz
Affiliation:
Unidad de Apoyo Técnico a la Investigación, Gerencia de Atención Primaria de Madrid, Spain
Asuncion Cañada-Dorado
Affiliation:
Dirección Técnica de Procesos y Calidad, Gerencia Atención Primaria de Madrid, Spain
Miguel Angel Salinero-Fort
Affiliation:
Fundación Investigación Biomedica, Hospital Carlos III Madrid, Spain
Manuela Medina-Fernández
Affiliation:
Centro de Salud Miraflores, Gerencia de Atención Primaria de Madrid, Spain
Enrique Carrillo de Santa Pau
Affiliation:
Unidad de Apoyo a la Investigación, Gerencia de Atención Primaria de Madrid, Spain
Paloma Gómez-Campelo
Affiliation:
Unidad de Epidemiología Clínica, Hospital Carlos III Madrid, Spain
Juan Carlos Abánades-Herranz
Affiliation:
Unidad de Docencia e Investigación, Gerencia de Atención Primaria de Madrid, Spain
*
Centra de Salud Monóvar, Gerencia de Atencion Primaria de Madrid, Spain ([email protected])
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Abstract

Objective.

To evaluate the effectiveness of a multimodal intervention in primary care health professionals for improved compliance with hand hygiene practice, based on the World Health Organization's 5 Moments for Health Hygiene.

Design.

Cluster randomized trial, parallel 2-group study (intervention and control).

Setting.

Primary healthcare centers in Madrid, Spain.

Participants.

Eleven healthcare centers with 198 healthcare workers (general practitioners, nurses, pediatricians, auxiliary nurses, midwives, odontostomatologists, and dental hygienists).

Methods.

The multimodal hand hygiene improvement strategy consisted of training of healthcare workers by teaching sessions, implementation of hydroalcoholic solutions, and installation of reminder posters. The hand hygiene compliance level was evaluated by observation during regular care activities in the office visit setting, at the baseline moment, and 6 months after the intervention, all by a single external observer.

Results.

The overall baseline compliance level was 8.1% (95% confidence interval [CI], 6.2-10.1), and the healthcare workers of the intervention group increased their hand hygiene compliance level by 21.6% (95% CI, 13.83-28.48) compared with the control group.

Conclusions.

This study has demonstrated that hand hygiene compliance in primary healthcare workers can be improved with a multimodal hand hygiene improvement strategy.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 7 , July 2012 , pp. 681 - 688
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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