Table 2. Hygiene and infection control.
| First author, year | Study design, intervention length, number of sites, baseline sample size | Control condition | Education material | Training | Reminders | Audit and feedback | Mentoring or support | Champion/s | Team meetings | Policy/procedure changes | Organizational restructure | Intervention description | Staff direct behavior outcomes | Staff indirect outcomes | Resident outcomes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Makris, 2000 | Paired, clustered randomized RCT, 52 wks, 8 sites, CG: 447 res; IG: 443 res | Usual policy | + | + | + | Training on infection, preventing disease transmission, control of food borne illness, food safety, cleaning and disinfecting surfaces and equipment. Handouts provided. Infection control nurse and departmental directors of homes responsible for providing education to new staff. Certified infection control professionals provided on-site visits. Germicidal products provided. | No differences between groups on combined infections, genitourinary, cutaneous, lower respiratory, gastrointestinal, other or upper respiratory infections. | ||||||||
| Baldwin, 2010 | Paired, randomized RCT, 52 wks, 32 sites, CG: 169 staff, 401 res; IG: 164 staff, 392 res | Usual care | + | + | + | Training for all staff—hand hygiene and decontamination demonstrations, audit and feedback of infection control, link worker to reinforce good infection control. | Compared to CG, IG infection control audit scores were higher over time. | No difference between groups in staff methicillin resistant staphylococcus aureus (MRSA) | No differences between groups on residents with methicillin resistant staphylococcus aureus (MRSA) | ||||||
| Ho, 2012 | Cluster randomized RCT, 4 wks, 4 months follow-up, 18 sites, CG: 711 res, 231 staff; IG1: 767 res, 248 staff; | Usual care | + | + | + | + | + | IG1: Slightly powdered gloves provided at points of care. Posters and reminders. Training on hand hygiene. Observations of hygiene in practice with feedback offered. | Compared to CG, IG1 and IG2 both showed improved hand hygiene. | Compared to CG, both IGs showed reduction in hospitalization related to respiratory outbreaks or methicillin resistant staphylococcus aureus (MRSA) infections. | |||||
| IG2: 929 res, 331 staff | + | + | + | IG2: As for IG1 except gloves were powderless and no specific feedback. |
RCT, randomized controlled trial; CG, control group; IG, intervention group; IG1, intervention group 1; IG2. Intervention group 2; wks, weeks; res, residents.