Abstract:
objective. To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multi- dimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance. design. An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period. setting. Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey. participants. Healthcare workers at 99 ICU members of the INICC. methods. A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods. results. A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3percent to 71.4percent (P .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63percent vs 70percent; P .001), physicians versus nurses (62percent vs 72percent; P .001), and adult versus neonatal ICUs (67percent vs 81percent; P .001), among others. conclusions. Adherence to hand hygiene increased by 48percent with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented. © 2013 by The Society for Healthcare Epidemiology of America. All rights reserved.