Effectiveness of an intervention to improve the compliance of hand hygiene in a tertiary hospital

Objective: The aim of the study is to assess the effectiveness of an intervention to improve the compliance with hand hygiene (HH) and the detection of factors associated with noncompliance. Methods: A before and after intervention study with two cross-sectional and direct observations of HH compliance was performed. The intervention was targeted at all the health workers and hospital departments directly related with patients and their healthcare environment. One hundred and sixty observation periods were included in each cross-sectional observation, accounting for a total of 5,245 observed opportunities of HH among 947 health workers. Results: Hand hygiene compliance showed a significant increase of 7.7% ( 95% CI: 5.5-9.9; P<.001) with a pre- intervention and post-intervention HH compliance of 17.4% (95% CI: 16.0-18.9) and 25.5% (95% CI: 23.5-26.9), respectively. The following variables showed an independent association with the non-compliance of HH: morning shift (0.32; 95% CI: 0.24-0.42), being a nurse (OR: 0.44; 95% CI: 0.29-0.65), working in an intensive care unit (OR: 0.14: 95% CI: 0.10-0.18), non-use of gloves (OR: 0.58: 95% CI: 0.48-0.69), observed opportunities of HH arising after high risk contact (OR: 0.30: 95% CI: 0.22-0.41) and after low risk contact (OR: 0.43: 95% CI: 0.32-0.58). Conclusions: The intervention has independently and significantly improved hand hygiene in the hospital. Multimodal strategies need to be designed in healthcare settings in order to increase HH compliance among health workers. (C) 2011 SECA. Published by Elsevier Espaoa, S. L. All rights reserved.