Impacto de la mejora de la higiene de las manos sobre las infecciones hospitalarias / Assessment of a hand hygiene program on healthcare-associated infection control

Objetivo. Evaluar el impacto de una campaña de promoción de la higiene de manos sobre las tasas de infección en un hospital de tercer nivel en Las Palmas de Gran Canaria. Métodos. Estudio descriptivo ecológico, valorando frecuencia de higiene de manos en 3 áreas asistenciales y las tasas de infecciones. Se consideraron 4 momentos temporales: basal (2005), fase 1 de intervención (2006), fase 2 de intervención (2007) y postintervención (2008). La intervención consistió en introducir productos de base alcohólica, feedback sobre resultados de cumplimiento, diseño y colocación de carteles y sesiones de educación sanitaria, con demostraciones prácticas. Se usaron criterios estandarizados para medir variables. Resultados. Se detectó un incremento en la tasa de cumplimiento a lo largo de los 3 periodos, desde el 19,6% en el periodo basal, al 40,0% final (p<0,001). El incremento del cumplimiento fue más acusado entre las oportunidades de riesgo alto (del 12,0–28,4%; p<0,001), aunque solo tras la primera fase de la campaña y entre las de riesgo medio (del 23,6–41,7%; p<0,001). No obstante, los indicadores de infección aumentaron en todas las áreas vigiladas, en especial la prevalencia de pacientes infectados, del 8% en 2005 al 12,2% en el año 2008. Conclusiones. A pesar del incremento en el cumplimiento de la higiene de manos en las áreas vigiladas, no se han conseguido reducir las tasas de infecciones nosocomiales en el hospital. Una estrategia más eficiente debería implicar a responsables clínicos y directivos en todos los aspectos del control de las infecciones(AU)

Aim. to assess the impact of a hand hygiene campaign on the rate of healthcare-associated infections in a teaching hospital in Las Palmas. Methods. Ecological design by hand hygiene frequency measurement at three high risk areas along with infection rates calculation over four periods of time: baseline (2005), phase 1 (2006), phase 2 (2007), and post-intervention (2008). Multi-modal intervention comprised the introduction of alcoholic solutions for rubbing hands, feedback on observed compliance, design and placement of posters, and healthcare workers training through all clinician areas. Variables measurement was carried out according to standardized criteria. Results. an increase in hand hygiene compliance was achieved over the tree periods of compliance surveillance, from 19,6% at baseline to 40,0% (p<0,001) at the last period. The increase was higher among those opportunities for hand hygiene considered as high risk for pathogen transmission (from 12,0% to 28,4%; p<0,001), but only after phase 1, and for medium risk opportunities. Infection rates did not low in every area under surveillance, especially prevalence of infected patients, which increased from 8% in 2005 to 12,2% in 2008. Conclusions. Despite the increase in adherence to hand hygiene at the areas under surveillance, health-care associated infections were not lowered hospital-wide. A more comprehensive strategy should be implemented, increasing managers and directors support in every task related to infection control(AU)

[Assessment of a hand hygiene program on healthcare-associated infection control]. / Impacto de la mejora de la higiene de las manos sobre las infecciones hospitalarias.

AIM: to assess the impact of a hand hygiene campaign on the rate of healthcare-associated infections in a teaching hospital in Las Palmas. METHODS: Ecological design by hand hygiene frequency measurement at three high risk areas along with infection rates calculation over four periods of time: baseline (2005), phase 1 (2006), phase 2 (2007), and post-intervention (2008). Multi-modal intervention comprised the introduction of alcoholic solutions for rubbing hands, feedback on observed compliance, design and placement of posters, and healthcare workers training through all clinician areas. Variables measurement was carried out according to standardized criteria. RESULTS: an increase in hand hygiene compliance was achieved over the tree periods of compliance surveillance, from 19.6% at baseline to 40.0% (p<0.001) at the last period. The increase was higher among those opportunities for hand hygiene considered as high risk for pathogen transmission (from 12.0% to 28.4%; p<0.001), but only after phase 1, and for medium risk opportunities. Infection rates did not low in every area under surveillance, especially prevalence of infected patients, which increased from 8% in 2005 to 12.2% in 2008. CONCLUSIONS: Despite the increase in adherence to hand hygiene at the areas under surveillance, health-care associated infections were not lowered hospital-wide. A more comprehensive strategy should be implemented, increasing managers and directors support in every task related to infection control.