Impact of national policy on hand hygiene promotion activities in hospitals in Korea

Background After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the Government established a strategy for infection prevention to encourage infection control activities in hospitals. The new policy was announced in December 2015 and implemented in September 2016. The aim of this study is to evaluate how infection control activities improved within Korean hospitals after the change in government policy. Methods Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using a multivariable linear regression model, we analyzed the change in total HHSAF score according to survey year. Results A total of 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In the multivariable linear regression model, total HHSAF score was significantly associated with hospital teaching status (beta coefficient of major teaching hospital, 52.6; 95% confidence interval [CI], 8.9 to 96.4;P = 0.018), beds size (beta coefficient of 100 beds increase, 5.1; 95% CI, 0.3 to 9.8;P = 0.038), and survey time (beta coefficient of 2017 survey, 45.1; 95% CI, 19.3 to 70.9;P = 0.001). Conclusions After the new national policy was implemented, the number of infection control professionals increased, and hand hygiene promotion activities were strengthened across Korean hospitals.