Efectividad de una intervención para la mejora del cumplimiento en la higiene de manos en un hospital de tercer nivel / Effectiveness of an intervention to improve the compliance of hand hygiene in a tertiary hospital

Objetivo. El objetivo es evaluar la efectividad de una intervención orientada a la higiene de manos (HM) así como la identificación de los factores relacionados con el no cumplimiento. Material y métodos. Estudio de intervención antes-después con dos cortes transversales de observación directa de cumplimiento de HM. La intervención se dirigió a todos los profesionales sanitarios y servicios hospitalarios que tienen contacto directo con los pacientes o el medio ambiente que los rodea. Se realizaron 160 periodos de observación en cada corte, registrándose 5.245 oportunidades de HM (OHM) en 947 profesionales. Resultados. Se observa un incremento significativo del 7,7% (intervalo de confianza (IC) 95%: 5,5-9,9; p<0,001) en el grado de cumplimiento de HM (pre-intervención: 17,4% [IC 95%: 16,0-18,9]; post-intervención: 25,2% [IC 95%: 23,5-26,9]). El turno de mañana (odds ratio (OR): 0,32; IC 95%: 0,24-0,42), la categoría de enfermería (OR: 0,44; IC 95%: 0,29-0,65), el área de cuidados intensivos (OR: 0,14; IC 95%: 0,10-0,18), el no uso de guantes (OR: 0,58; IC 95%: 0,48-0,69), las OHM realizadas después de contactos de alto riesgo (OR: 0,30: IC 95%: 0,22-0,41) y después de contactos de bajo riesgo (OR: 0,43; IC 95%: 0,32-0,58) se relacionaron de manera independiente con el no cumplimiento. Conclusiones. La campaña realizada mostró un efecto independiente significativo en la mejora de la HM. Es necesario el diseño en los centros sanitarios de estrategias multimodales para incrementar la HM en los profesionales(AU)

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 non-compliance. 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(AU)

[Effectiveness of an intervention to improve the compliance of hand hygiene in a tertiary hospital]. / Efectividad de una intervención para la mejora del cumplimiento en la higiene de manos en un hospital de tercer nivel.

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 non-compliance. 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.

Virus de la gripe y virus respiratorio sincitial: estrategias de inmunización activa / The flu virus and syncytial respiratory virus: strategies for active immunisation

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