Table V.
Intervention types and compliance outcomes
| Study | Year | Type of intervention(s) | No. of interventions | Compliance at baseline | Compliance post intervention (effect increase/decrease) |
|---|---|---|---|---|---|
| Aghdassi et al. [43] | 2020 | Education and training, reminder, infrastructural improvement, feedback | 4 | 59% | 61% (+2%) P=0.03 |
| Apisarnthanarak et al. [55]c | 2015 | Education and training, infrastructural improvement | 2 | 66% | 84% (+18%) P=0.84, 0.02, 0.005 |
| Benudis et al. [66] | 2020 | Reminders | 1 | Clear percentage data could not be extrapolated from the paper which reports that HH compliance improved by 1.3 percentage points per month during the intervention period, P=0.0005 | |
| Beyfus et al. [49] | 2016 | Reminders | 1 | HHOs only (dispenser volume). Average volume dispensed in stations with eyes was 279 cc vs 246 cc in stations without eyes, P=0.009 | |
| Chakravarthy et al. [41] | 2015 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 37% | 82% (+45%) P=0.0001 |
| Chhapola and Brar [79] | 2015 | Education and training, reminders, feedback | 3 | 46% | 69% (+23%) P≤0.0001 |
| Diefenbacher et al. [65] | 2019 | Feedback, leadership, teamwork | 3 | HHOs alone. HH dispenser usage almost doubled during the intervention, and increases were sustained during the post-intervention phase, P=0.004 | |
| Derde et al. [35] | 2014 | Education and training | 1 | 52% | 77% (+25%) P-value not stated |
| Derksen et al. [74] | 2020 | Reminders, infrastructural improvement | 2 | 47% | 95% (+48%) P<0.001 |
| Donati et al. [85] | 2020 | Education and training, reminders, feedback, leadership | 4 | 63% | 77% (+14%) P=0.031 |
| Ellison et al. [48] | 2015 | Reminders | 1 | 26% | 37% (+11%) P<0.001 |
| Farhoudi et al. [88] | 2016 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 30% | 71% (+41%) P<0.001 |
| Fouad and Eltaher. [71] | 2020 | Education and training, feedback | 2 | 31% | 46% (+15%) P<0.01 |
| Fox et al. [81] | 2015 | Education and training, reminders, feedback | 3 | 48% | 75% (+27%) P-value not stated |
| Harrabi et al. [57] b | 2017 | Intervention not described in detail | Intervention not described in detail | 70% | 77% (+7%) P-value not stated |
| Kai et al. [50] | 2020 | Education and training | 1 | 6% | 56% (+50%) P<0.0001 |
| Khan and Nausheen [54] | 2017 | Feedback | 1 | 15% | 81% (+66%) P<0.0001 |
| King et al. [75] | 2016 | Reminders | 2 (sensory and visual cue are two separate reminders) | 15% | 47% (+32%) olfactory prime, P=0.0001; male eyes, P=0.038; female eyes, P=0.626 |
| Kuruno et al. [72] | 2017 | Education and training, feedback | 2 | 16% | 57% (+41%) P<0.05 |
| Labi et al. [40] | 2019 | Education and training, infrastructural improvement, leadershipa | 2 | 29% | 68% (+39%) P<0.0001 |
| Larson et al. [63] | 2018 | Education and training, feedback, leadership, teamwork | 4 | HHOs alone. Increase in number of HH events in one of three sites, P=0.0003. Results for Site 1 were not significant, P=0.59 | |
| Laurikainen et al. [53] | 2016 | Feedback | 1 | HHOs alone. Post intervention showed increases in ABHR dispenser usage in one of three sites, P=0.0003 | |
| Lea et al. [70] | 2016 | Leadership | 1 | 38% | 67% (+29%) P-value not stated |
| Lee et al. [62]b | 2020 | Education and training, leadership, teamwork | 3 | 49% | 66% (+17%) P-value not stated |
| Lytsy et al. [36]b | 2016 | Education and training, feedback | 2 | 78% | 79% (+1%) P-value not stated |
| Marra et al. [73] | 2014 | Reminders, feedback, leadershipa | 2 | HHOs alone. ABHR dispenser usage higher in intervention units. P-values varied by study site, all were significant | |
| Medeiros et al. [89] | 2015 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 27% | 58% (+31%) P=0.0001 |
| Moller-Sorenson et al. [47] | 2016 | Reminders | 1 | 66% | 91% (+25%) P<0.0001 |
| Mu et al. [82] | 2016 | Education and training, infrastructural improvement, feedback, leadership | 4 | 38% | 76% (+38%) P<0.0001 |
| Mukherjee et al. [51] | 2020 | Education and training, feedback, leadership | 3 | 34% | 100% (+66%) P-value not stated |
| Muller et al. [68] | 2014 | Feedback | 1 | 66% | 68% (+2%) P-value not stated |
| Ng et al. [78]b | 2019 | Education and training, infrastructural improvement, leadership | 3 | 64% | 82% (+16%) P=0.01 |
| Nobile et al. [3] | 2018 | Education and training, feedback, leadershipa | 2 | HHOs alone. Decrease in breaches of HH protocol during intervention period, P=0.000 | |
| Nour-Eldein and Ali Mohamed [59] | 2016 | Education and training | 1 | 20% | 50% (+30%) P<0.001 |
| Nyamadzawo et al. [39] | 2020 | Education and training, infrastructural improvement | 2 | 48% | 68% (+20%) P<0.001 |
| Pong et al. [64] | 2018 | Education and training, reminders, feedback, teamwork | 4 | 25% | 63% (+38%) P<0.0001 |
| Reisinger et al. [44]c | 2014 | Reminders | 1 | 34% on room entry, 52% on room exit | 39% on entry into room, P=0.79; 57% on exit from room, P=0.54 |
| Renaudin et al. [60]b | 2017 | Education and training | 1 | 88% | 77% (-11%) P-value not stated |
| Rodrigeuz et al. [87]b | 2015 | Education and training, reminders, infrastructural improvements, feedback, leadership | 5 | 62% | 76% (+14%) P<0.0001 |
| Saharman et al. [84] | 2019 | Education and training, reminders, feedback, leadership | 4 | 27% | 77% (+50%) P<0.001 |
| Santoaningsih et al. [77]b | 2017 | Education and training, leadership | 2 | 16% | 27% (+11%) P<0.001 |
| Schmitz et al. [37] | 2014 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 2% | 12% (+10%) P<0.001 |
| Sopirala et al. [12] | 2014 | Education and training, reminders, feedback, leadership | 4 | 30% | 93% (+63%) P=0.001 |
| Staats [42] | 2017 | Reminders | 1 | HHOs alone. Total dispenser use increased by 62.02%, P<0.0001 | |
| Stevenson et al. [83] | 2014 | Education and training, reminders, infrastructural improvement, feedback | 4 | HHOs alone. HHOs increased by 20.1% compared with 3.1% in control group, baseline not specified, P=0.001 | |
| Stewardson et al. [61] | 2016 | Education and training, reminders, infrastructural improvement, feedback, leadership, teamwork | 5 | 66% | 74% (+8%) P<0.0001 |
| Su et al. [86] | 2015 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 52% | 80% (+28%) P=0.004 |
| Teesing et al. [90] | 2020 | Education and training, reminders, feedback, leadership, teamwork | 5 | 12% | 36% (+14%) P-value not stated |
| Tschudin-Sutter et al. [80] | 2019 | Education and training, reminders, feedback | 3 | HH baseline not clearly stated | |
| van der Kooi et al. [58] | 2018 | Education and training | 1 | 36% | 58% (+22%) P<0.0001 |
| Vander Weg et al. [67]b | 2019 | Reminders | 1 | 56% | 57% (+1%) P=0.14, P=0.06 |
| Visnovsky et al. [69]c | 2019 | Infrastructural improvement (intervention involved reduction in contact precautions) | 1 | HH compliance net change could not be extrapolated. Data not significant for effect when personal protective equipment removed, P=0.07; or for change in intervention group, P=0.29 | |
| von Lengerke et al. [46] | 2017 | Education and training, feedback, leadershipa | 2 | 54% | 70% (+16%) P=0.005 |
| von Lengerke et al. [45] | 2019 | Education and training, feedback, leadershipa | 2 | 54% | 70% (+16%) P=0.005 |
| Wiedenmayer et al. [38] | 2020 | Education and training, reminders, infrastructural improvement, feedback, leadership | 5 | 30% | 56% (+26%) P<0.001 |
| Xiong et al. [56] | 2016 | Education and training | 1 | Records increase in intervention group performance of proper HH technique, P=0.00. Percentage compliance data for HHOs not recorded | |
| Yilmaz et al. [52]b | 2016 | Education and training, feedback | 2 | 28% | 73% (+45%) P<0.001 |
| Mean HH compliance | Mean baseline 41% | Mean post intervention 67% (mean net effect +26%) |
ABHR, alcohol-based hand rub; HH, hand hygiene; HHO, hand hygiene opportunity.
All percentage data have been rounded to the nearest integer. Studies that did not record compliance percentage data are marked as HHO alone. Where data could not be extrapolated from the studies, this is noted in the ‘Compliance post intervention’ column.
a
Leadership is alluded to in the study but not considered by this review to be part of the intervention. This is discussed further in the Results section under ‘Hand hygiene compliance interventions’.
b
Data were extrapolated from figures provided in the tables of these papers.
c
Study was excluded from mean calculations as the results failed to reach significance.