Steady amelioration of institutional hand hygiene behavior among health care personnel after 12-year consistent intervention

Am J Infect Control. 2023 Feb 1;S0196-6553(23)00050-0. doi: 10.1016/j.ajic.2023.01.009. Online ahead of print.


Background: Institutional hand hygiene (HH) behavior is difficult to monitor and improve consistently, especially over long periods. This study aimed to investigate the long-term effects of HH promotion activities.

Method: We launched the HH promotion team in 2010 and conducted interventions including goal setting, observation and feedback, education, reward incentives, and accountability. Optimal HH compliance rates were calculated based on adherence to all 6-step HH technique and appropriate time recommended by the World Health Organization. HH and optimal HH compliance were calculated over 12 years. Poisson regression analysis was used to determine the trend in HH compliance according to year.

Results: In 2010, HH and optimal HH compliance were 59.7% and 15.6%, respectively. HH compliance increased by 83.9% in 2013 and remained over 75%. HH compliance increased significantly, with a relative risk (RR) of 1.014 (95% CI 1.002-1.025, P = .018). Optimal HH compliance increased by 67.8% in 2013 and remained over 60%, except in 2016 (58.8%) and 2019 (59.8%). Optimal HH compliance increased with RR 1.033 (95% CI 0.991-1.076, P = .123).

Discussion: HH and optimal HH compliance increased significantly over the 12 years when subgroup analysis was performed by job category.

Conclusions: HH promotion team activities improved and maintained optimal HH compliance among HCWs.

Keywords: Campaign; Hand hygiene; Health care workers; Promotion.