TABLE 11.
Compliance rates in hand hygiene, according to the agent and intervention
| Type of ward(s) | Agent(s)a (baseline) | Main active agent(s)a (new) | Intervention(s) | Compliance rate (%)
|
Main reason(s) for change | Reference | |
|---|---|---|---|---|---|---|---|
| Baseline | After intervention | ||||||
| ICU | Soap | Soap | Lectures, feedback, demonstrations | 5 | 63 | Lectures, feedback, demonstrations | 51 |
| ICU | Soap | Soap | New design of ICU | 16 | 30 | More convenient sink location | 446 |
| ICU | Soap | Soap | Education | 22.0 | 29.9 | Education | 518 |
| ICU | Soap | Soap | Lectures and reminder labels on ventilators | 46 (before patient contact), 83 (after patient contact) | 92 (before patient contact), 92 (after patient contact) | Lectures and reminder labels on ventilators | 264 |
| Pediatric ambulatory setting | Soap | Soap | Use of reminders | 49 | 49 | Use of reminders | 324 |
| Pediatric wards | Soap | Soap | Educational program | 52 | 74 | Educational program | 31 |
| Emergency department | Soap | Soap | Posting of signs, education | 54 | 64 | Posting of signs, education | 120 |
| Neonatal ICU | Soap | Soap | Use of gowns | 62 | 60 | Use of gowns | 421 |
| ICU | Soap | Soap | Performance feedback and new soap | 63 | 92 | Performance feedback | 352 |
| ICU | Soap | Soap | Education and feedback | 81 | 92 | Education and feedback | 122 |
| Surgical ICU | Plain and medicated soap (chlorhexidine) | Plain and medicated soap (chlorhexidine) | Automatic hand-washing machines available | 22 | 38 | Availability of hand-washing machines | 618 |
| New-burn nursersies | Medicated soap | Medicated soap | Feedback | 28 | 63 | Feedback | 451 |
| Medical ICU | Medicated soap | Medicated soap | Routine wearing of gowns and gloves, educational meetings | 40.8 | 58.2 | Routine wearing of gowns and gloves, educational meetings | 521 |
| ICU | Medicated soap (para-chloro- metaxylenol) | Medicated soap (para-chlorometaxylenol) | Teaching and reminders (buttons) | 22 | 29.9 | Reminders | 518 |
| Medical ICU | Medicated soap (4% chlorhexidine) | Medicated soap (4% chlorhexidine) | Education | 26% (before patient contact), 23% (after patient contact) | 38% (before patient contact), 60% (after patient contact) | Education | 91 |
| Pediatric ICU | Soap (plain and medicated), ethanol (70%), aqueous povidone iodine | Soap (plain and medicated), ethanol (70%), aqueous povidone iodine | Overt observation and feedback | 12% (before patient contact), 11% (after patient contact) | 68% (before patient contact), 65% (after patient contact) | Overt observation and feedback | 559 |
| ICU | Soap | Ethanol (60%) | Quality improvement and introduction of hand gel | 42.5 | 35.1 | “Sticky uncomfortable feeling” of product | 197 |
| ICU and medical ward | Plain and medicated soap (4% chlorhexidine) | Ethanol (60%) | Education program followed by introduction of hand rub | 16.3 | 20.9 (after education), 33.2 (after introduction of hand rub) | Easy access of hand rub | 63 |
| Medical ICU and ward | Soap | Ethanol (62%) | Introduction of hand rub with an educational and motivational campaign; wall dispensers | Overall, 60%; medical ICU, 70.3%; ward, 46.2% | Overall, 52%; Medical ICU, 58%; ward, 48% | Physicians as role models | 388 |
| Plastic surgery department | Soap | Ethanol (70%) | Performance feedback | 62 | 61.3 | Performance feedback | 336 |
| Neonatal ICU | Plain soap | Ethanol (79%) | Introduction of hand rub and quality improvement | 44 | 48 | Unknown | 75 |
| ICU | Soap | Isopropanol (60%) | Introduction of hand rub and teaching | 32 | 45 | Accessability of hand rub | 180 |
| ICU | Plain soap | Isopropanol (75%) | Promotion campaign for hand hygiene | 38.4 | 54.5 | Campaign on benefits of alcohol-based hand rubs | 223 |
| All | Isopropanol (75%) | Promotion campaign for hand hygiene | 48 | 66 | Campaign on benefits of alcohol-based hand rubs | 439 | |
| Medical ICU | Plain soap | Isopropanol (45%) and n-propanol (30%) | Introduction of hand rub and education | 42.2 | 60.9 | Availability of hand rub; short time for hand rub procedure | 351 |
| All | Soap (plain and medicated) | Isopropanol (45%) and n-propanol (30%) | Introduction of hand rub and education | 62.2 | 66.5 | Better dermal tolerance of hand rub | 167 |
| All | Soap (plain and medicated) | Isopropanol (45%) and n-propanol (30%) | Introduction of hand rub and education | 52 | 66 | Dermal tolerance and accessibility | 169 |
a
“Soap” was always assumed to be meant when “hand washing” was mentioned in a study; it may include plain and medicated soap.