Hand-hygiene compliance by hospital staff and incidence of health-care-associated infections, Finland
Ojanperä, Helena; Kanste, Outi I.; Syrjala, Hannu (2020-07-01)
Ojanperä, H., Kanste, O., Syrjala, H. (2020) Hand-hygiene compliance by hospital staff and incidence of health-care-associated infections, Finland. Bulletin of the World Health Organization, 98 (7), 475-483. doi:10.2471/BLT.19.247494
The Bulletin is a fully open-access journal with no article-processing charges. All articles are available under the Creative Commons Attribution 3.0 IGO licence (CC BY 3.0 IG0) and are freely available online: http://www.who.int/bulletin/volumes/en/.
https://creativecommons.org/licenses/by/3.0/
https://urn.fi/URN:NBN:fi-fe2020120198877
Tiivistelmä
Abstract
Objective: To determine changes in hand-hygiene compliance after the introduction of direct observation of hand-hygiene practice for doctors and nurses, and evaluate the relationship between the changes and the incidence of health-care-associated infections.
Methods: We conducted an internal audit survey in a tertiary-care hospital in Finland from 2013 to 2018. Infection-control link nurses observed hand-hygiene practices based on the World Health Organization’s strategy for hand hygiene. We calculated hand-hygiene compliance as the number of observations where necessary hand-hygiene was practised divided by the total number of observations where hand hygiene was needed. We determined the incidence of health-care-associated infections using a semi-automated electronic incidence surveillance programme. We calculated the Pearson correlation coefficient (r) to evaluate the relationship between the incidence of health-care-associated infections and compliance with hand hygiene.
Findings: The link nurses made 52 115 hand-hygiene observations between 2013 and 2018. Annual hand-hygiene compliance increased significantly from 76.4% (2762/3617) in 2013 to 88.5% (9034/10 211) in 2018 (P < 0.0001). Over the same time, the number of health-care-associated infections decreased from 2012 to 1831, and their incidence per 1000 patient-days fell from 14.0 to 11.7 (P < 0.0001). We found a weak but statistically significant negative correlation between the monthly incidence of health-care-associated infections and hand-hygiene compliance (r = −0.48; P < 0.001).
Conclusion: The compliance of doctors and nurses with hand-hygiene practices improved with direct observation and feedback, and this change was associated with a decrease in the incidence of health-care-associated infections. Further studies are needed to evaluate the contribution of hand hygiene to reducing health-care-associated infections.
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