Impact of a multimodal intervention program on hand hygiene compliance at Bangkok Tertiary Care Hospital

Authors

  • Wipaporn Natalie Songtaweesin Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Suvaporn Anugulruengkit Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Rujipat Samransamruajkit Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Darintr Sosothikul Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Mayuree Prinyawat King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Ornanong Tangsrijitdee King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Anry Nakphunsung King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Patchareeyawan Srimuan Chulalongkorn University, Bangkok, Thailand
  • Jiratchaya Sophonphan Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Chitsanu Pancharoen Chulalongkorn University, Bangkok, Thailand
  • Thanyawee Puthanakit Chulalongkorn University, Bangkok, Thailand

Keywords:

Hand hygiene compliance, handwashing, hospital acquired infections.

Abstract

Background: Implementation of handwashing in real life healthcare settings is challenging. Immense clinical benefits from hand hygiene (HH) compliance can be gained in resource-limited settings such as Thailand. Customized multimodal strategies to promote HH are advocated by World Health Organization.

Objectives: Good HH practices are a simple and cost-effective strategy to limit pathogen transmission between patients. This study explores the effect of a multimodal hand hygiene promotion program on HH compliance amongst healthcare workers.

Methods: A prospective study was conducted at the pediatric intensive care unit and pediatric immunocompromised ward. A baseline attitudes survey was performed by asking perceived barriers and motivators to HH compliance. Interventions performed were tailored according to this and included: HH promotion videos sent to staff via mobile phone, HH signs at the bedside, distribution of portable alcohol gel bottles, HH promotion culture led by senior staff members and fob watch prizes. HH compliance was assessed by direct observation using the WHO’s 5-moments for hand hygiene (WHO5HH) – before touching patients, before clean/aseptic procedures, after body fluid exposure risk, after touching patients, and after touching patient surroundings. A minimum of 200 opportunities in total were observed at pre-intervention and three times following intervention commencement. Hospital acquitted infection rates (HAIs) were routinely monitored during the study period.

Results: In December 2015, pre-intervention, overall HH compliance rates were 51.0% (95%CI 44 - 58). Between January and June 2016, post-intervention, overall HH compliance increased to 70.0% (95% CI 67 - 74) (P < 0.001). When divided into the five moments for HH, handwashing prior to touching patients significantly improved the following intervention from 44.0% to 87.0% (P < 0.001). HH after touching patient surroundings remained low. HH compliance was highest amongst nurses (55.0% at baseline and 83.0% with intervention). HAI rates were unchanged during the study period.

Conclusions: A multimodal HH promotion campaign tailored towards the local population was effective in increasing HH compliance overall. HAI rates were unchanged following HH compliance improvement.

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References

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Published

2023-07-27

How to Cite

1.
Natalie Songtaweesin W, Anugulruengkit S, Samransamruajkit R, Sosothikul D, Prinyawat M, Tangsrijitdee O, Nakphunsung A, Srimuan P, Sophonphan J, Pancharoen C, Puthanakit T. Impact of a multimodal intervention program on hand hygiene compliance at Bangkok Tertiary Care Hospital. Chula Med J [Internet]. 2023 Jul. 27 [cited 2024 Oct. 12];64(3). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/245