Is the World Health Organization Multimodal Hand Hygiene Improvement Strategy applicable and effective at the primary care level in resource-limited settings? A quantitative assessment in healthcare centers of Faranah, Guinea

Sophie Alice Müller; Lena Landsmann; Alpha Oumar Karim Diallo; Rebekah Wood; Carlos Rocha; Ousmane Tounkara; Mardjan Arvand; Mamadou Diallo; Matthias Borchert

doi:10.1016/j.ijregi.2022.03.002

Is the World Health Organization Multimodal Hand Hygiene Improvement Strategy applicable and effective at the primary care level in resource-limited settings? A quantitative assessment in healthcare centers of Faranah, Guinea

IJID Reg. 2022 Mar 3:3:27-33. doi: 10.1016/j.ijregi.2022.03.002. eCollection 2022 Jun.

Authors

Sophie Alice Müller¹, Lena Landsmann², Alpha Oumar Karim Diallo³, Rebekah Wood¹, Carlos Rocha¹, Ousmane Tounkara³, Mardjan Arvand², Mamadou Diallo³, Matthias Borchert¹

Affiliations

¹ Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany.
² Unit for Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany.
³ Faranah Regional Hospital, Faranah, Guinea.

Abstract

Background: The World Health Organization Multimodal Hand Hygiene Improvement Strategy aims at reducing healthcare-associated infections; however, evidence of applicability and effectiveness at the primary care level is scarce, especially in healthcare centers in resource-limited settings. The objectives of this study were to improve hand hygiene knowledge and compliance at two healthcare centers in the region of Faranah, Guinea, to increase the availability of alcohol-based hand rub (ABHR), and to assess the effectiveness of the strategy at the primary care level.

Methods: Knowledge, perceptions, and compliance were assessed prior to the intervention and compared to those of two follow-up assessments, immediately and 6 months after the intervention. The intervention consisted of training and the supply of ABHR. The monthly consumption of ABHR was monitored.

Results: Baseline knowledge increased from a score of 11/25 at baseline to 16/25 at first follow-up; it then decreased to 15/25 at the second follow-up. Compliance showed an increase from 15.6% to 84.4% (P < 0.001) at the first follow-up. At the second follow-up, compliance was lower than at the first follow-up (53.2%, P < 0.001), but still more than two times higher than at baseline (P < 0.001). ABHR consumption averaged 0.77 ml per consultation.

Conclusions: The World Health Organization hand hygiene strategy is an appropriate method to improve compliance and knowledge at the primary care level, but needs some adjustment: the inclusion of observation of the correctness of hand hygiene action, as well as training emphasizing the amount of ABHR to use.

Keywords: 5 Moments of Hand Hygiene; ABHR, alcohol-based hand-rub; Alcohol-based hand rub; FRH, Faranah Regional Hospital; HAI, healthcare-associated infections; HCC, healthcare center; HCW, healthcare worker; HH, hand hygiene; Hand hygiene; Healthcare centers; Healthcare-associated infections; IPC, infection prevention and control; IQR, interquartile range; Local disinfectant production; OR, odds ratio; PASQUALE, Partnership to Improve Patient Safety and Quality of Care; WHO, World Health Organization.