A systematic review of hand hygiene improvement strategies: a behavioural approach
Implementation SciencePublished 14 September 2012Open access
Anita Huis, Theo van Achterberg, Marijn de Bruin, Richard Grol, Lisette Schoonhoven, Marlies Hulscher
Citations254
SJR quartileQ1
SJR score4.49
SNIP4.44
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
By focussing on determinants of behaviour change, we found hidden and valuable components in HH improvement strategies. Addressing only determinants such as knowledge, awareness, action control, and facilitation is not enough to change HH behaviour. Addressing combinations of different determinants showed better results. This indicates that we should be more creative in the application of alternative improvement activities addressing determinants such as social influence, attitude, self-efficacy, or intention.
Keywords
Agricultural and Biological SciencesSocial SciencesMedicine
The LancetFrom best evidence to best practice: effective implementation of change in patients' care
4,473 Citations2003Richard Grol, Jeremy Grimshaw
Health Technology AssessmentEffectiveness and efficiency of guideline dissemination and implementation strategies
3,054 Citations2004Jeremy Grimshaw, Ruth Thomas +11 more
A systematic review of the effectiveness and costs of different guideline development, dissemination, and implementation strategies was taken and a framework for deciding when it is efficient to develop and introduce clinical guidelines was developed.
Public Health ReportsEstimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002
2,959 Citations2007R. Monina Klevens, Jonathan R. Edwards +5 more
HAIs in hospitals are a significant cause of morbidity and mortality in the United States and the method described for estimating the number of HAIs makes the best use of existing data at the national level.
Implementation ScienceA conceptual framework for implementation fidelity
2,580 Citations2007Christopher Carroll, Malcolm Patterson +4 more
Health PsychologyA taxonomy of behavior change techniques used in interventions.
2,562 Citations2008Charles Abraham, Susan Michie
These findings demonstrate the feasibility of developing standardized definitions of BCTs included in behavioral interventions and highlight problematic variability in the reporting of intervention content.
The LancetEffectiveness of a hospital-wide programme to improve compliance with hand hygiene
2,488 Citations2000Didier Pittet, Stéphane Hugonnet +5 more
The campaign produced a sustained improvement in compliance with hand hygiene, coinciding with a reduction of nosocomial infections and MRSA transmission, and the promotion of bedside, antiseptic handrubs largely contributed to the increase in compliance.
BMJClosing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings
2,337 Citations1998Lisa Bero, Roberto Grilli +4 more
This paper examines systematic reviews of different strategies for the dissemination and implementation of research findings to identify evidence of the effectiveness of different strategies and to assess the quality of the systematic reviews.
PubMedMaking health care safer: a critical analysis of patient safety practices.
1,630 Citations2001Kaveh G Shojania, Ben Duncan +3 more
This project aimed to collect and critically review the existing evidence on practices relevant to improving patient safety and identify practices with the strongest supporting evidence that decrease the risks associated with hospitalization, critical care, or surgery.
Health Education & BehaviorIntervention Mapping: A Process for Developing Theory and Evidence-Based Health Education Programs
1,118 Citations1998L. Kay Bartholomew, Guy S. Parcel +1 more
Intervention Mapping is a framework for health education intervention development that is composed of five steps: creating a matrix of proximal program objectives, selecting theory-based intervention methods and practical strategies, designing and organizing a program, specifying adoption and implementation plans, and generating program evaluation plans.
Annals of Internal MedicineCompliance with Handwashing in a Teaching Hospital
996 Citations1999Didier Pittet, Philippe Mourouga +2 more
Variation across hospital ward and type of health care worker suggests that targeted educational programs may be useful and the association between noncompliance and intensity of care suggests that understaffing may decrease quality of patient care.
International Journal of Technology Assessment in Health CareEffectiveness and efficiency of guideline dissemination and implementation strategies
867 Citations2005Jeremy Grimshaw, Ruth Thomas +11 more
American Journal of Infection ControlAPIC guidelines for handwashing and hand antisepsis in health care settings
766 Citations1995Elaine Larson
Cochrane Database of Systematic ReviewsInterventions to improve hand hygiene compliance in patient care
667 Citations2017Dinah Gould, Donna Moralejo +3 more
The short- and long-term success of strategies to improve compliance to recommendations for hand hygiene are assessed, and whether an increase in hand hygiene compliance can reduce rates of health care-associated infection is determined.
Improving Patient Care: The Implementation of Change in Clinical Practice
553 Citations2005R. Grol, Michel Wensing +3 more
Infection Control and Hospital EpidemiologyImproving Compliance With Hand Hygiene in Hospitals
527 Citations2000Didier Pittet
Journal of General Internal MedicineToward Evidence-Based Quality Improvement.
503 Citations2006Jeremy Grimshaw, Martin Eccles +5 more
There is an imperfect evidence base to support decisions about which guideline dissemination and implementation strategies are likely to be efficient under different circumstances, and decision makers need to use considerable judgment about how best to use the limited resources they have for quality improvement activities.
Health Education QuarterlyGoal Setting as a Strategy for Health Behavior Change
457 Citations1995Victor J. Strecher, Gerard Seijts +6 more
The beneficial effects of setting goals in health behavior change and maintenance interventions and initial recommendations for the successful integration of goal setting theory in healthbehavior change programs are offered.
Behavioral MedicineAn Organizational Climate Intervention Associated With Increased Handwashing and Decreased Nosocomial Infections
406 Citations2000Elaine Larson, Eve Early +3 more
Staff in one of two hospitals in the mid-Atlantic region received an intervention with multiple components designed to change organizational culture and rates of MRSA and vancomycin-resistant enterococci were significantly reduced in the intervention hospital during implementation.
Infection Control and Hospital EpidemiologyA Causal Link Between Handwashing and Risk of Infection? Examination of the Evidence
369 Citations1988Elaine Larson
It was concluded that emphasis on handwashing as a primary infection control measure has not been misplaced and should continue.
PEDIATRICSHand Hygiene Practices in a Neonatal Intensive Care Unit: A Multimodal Intervention and Impact on Nosocomial Infection
356 Citations2004Barbara C.C. Lam, Josephine Lee +1 more
A concurrent decrease in health care–associated infection rate and increase in hand hygiene compliance was observed in this study, which could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance.
Journal of Hospital InfectionThe Second National Prevalence Survey of Infection in Hospitals—overview of the results
341 Citations1996A.M. Emmerson, J.E. Enstone +3 more
Assessment of the overall prevalence of infection among the patients in hospitals in the UK and the Republic of Ireland found that HAI rates were higher in teaching hospitals (11.2%) than in non-teaching hospitals (8.4%) P < 0.001.
American Journal of Infection ControlSystematic review of economic analyses of health care-associated infections
334 Citations2005Patricia W. Stone, Deborah Braccia +1 more
There are more publications and growing interest in estimating the costs of HAI, however, the methods employed vary and guidelines for authors and editors on conducting an economic analysis are recommended, and training of infection control professionals in economic methods are recommended.
Journal of Hospital InfectionThe effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review
302 Citations2001Suzan Naikoba, Andrew Hayward
Multifaceted approaches which combine education with written material, reminders and continued feedback of performance can have an important effect on handwashing compliance and rates of hospital-acquired infection.
American Journal of Infection ControlHandwashing practices in an intensive care unit: The effects of an educational program and its relationship to infection rates
280 Citations1989J. Conly, S. Hill +3 more
An educational and enforcement program designed to improve handwashing procedures can significantly reduce endemic nosocomial infection rates.
Journal of Hospital InfectionThe Lowbury lecture: behaviour in infection control
261 Citations2004Didier Pittet
The theory of ecological perspective, based on the idea that behaviour is viewed as being affected by and affecting multiple levels of influence, and that it both influences and is influenced by the social environment, seems promising to explain behaviour modification.
American Journal of Infection ControlA multifaceted approach to changing handwashing behavior
239 Citations1997Elaine Larson, Jacalyn L. Bryan +2 more
Intensive intervention, including feedback, education, and increased sink automation, had minimal long-term effect on handwashing frequency.
Journal of Nursing ScholarshipNursing Implementation Science: How Evidence‐Based Nursing Requires Evidence‐Based Implementation
218 Citations2008Theo van Achterberg, Lisette Schoonhoven +1 more
An analytical, deliberate process of clarifying implementation determinants and choosing strategies is needed to improve situations where suboptimal care exists and use of theory and evidence from implementation science can facilitate evidence-based implementation.
Infection Control and Hospital EpidemiologyHandwashing Program for the Prevention of Nosocomial Infections in a Neonatal Intensive Care Unit
209 Citations2004Sau-Pin Won, Hung‐Chieh Chou +5 more
Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular, and this program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques.
Infection Control and Hospital EpidemiologyThe Role of Handwashing in Prevention of Endemic Intensive Care Unit Infections
206 Citations1990Bryan Simmons, Jerri K. Bryant +3 more
It is concluded that handwashing rates, when measured against arbitrary but reasonable standards, are suboptimal, difficult to change and not closely related to evidence of cross-infection.
Health Promotion InternationalHow to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques
204 Citations2010Theo van Achterberg, Getty G. J. Huisman-de Waal +4 more
None of the behaviour change techniques demonstrated clear effects in a convincing majority of the studies in which they were evaluated, but self-monitoring of behaviour, risk communication and use of social support are most effective.
The Pediatric Infectious Disease JournalInterventional study to evaluate the impact of an alcohol-based hand gel in improving hand hygiene compliance
181 Citations2002Stephan Harbarth, Didier Pittet +5 more
A statistically significant, modest improvement in compliance is noted after introduction of an alcohol-based hand gel with multifaceted QI support, suggesting that alcohol- based HH may be effective in improving compliance.
Infection Control and Hospital EpidemiologyProspective, Controlled, Cross-Over Trial of Alcohol-Based Hand Gel in Critical Care Units
181 Citations2007Mark E. Rupp, Teresa Fitzgerald +10 more
The introduction of alcohol-based gel resulted in a significant and sustained improvement in the rate of hand hygiene adherence, and an increase in the number of microbes and an increased number of microbe species was associated with longer fingernails, wearing rings, and lack of access to hand gel.
Journal of Hospital InfectionPrevalence of nosocomial infections in hospitals in Norway, 2002 and 2003
174 Citations2005Hanne Merete Eriksen, Bjørn G Iversen +1 more
Nosocomial infections were located most frequently in the urinary tract, followed by the lower respiratory tract, surgical sites, surgical site infections and septicaemia, and the total prevalence varied between 5.1% and 5.4% in the four surveys.
American Journal of Infection ControlHand hygiene rates unaffected by installation of dispensers of a rapidly acting hand antiseptic
155 Citations2000Carlene A. Muto, Maria Gilson Sistrom +1 more
An educational campaign and installation of dispensers containing a rapidly acting hand hygiene product near hospital rooms did not affect hand hygiene compliance and the behavior of attending physicians was predictive of handwashing rates for all others in the attending's retinue.
Health PsychologyStandard care quality determines treatment outcomes in control groups of HAART-adherence intervention studies: Implications for the interpretation and comparison of intervention effects.
151 Citations2009Marijn de Bruin, Wolfgang Viechtbauer +3 more
Variation in SCQ provided to control groups may substantially influence effect sizes of behavior change interventions, and future trials should assess and report SCQ, and meta-analyses should control for variability inSCQ, thereby producing more accurate estimates of the effectiveness ofbehavior change interventions.
Infection Control and Hospital EpidemiologyMulticenter Intervention Program to Increase Adherence to Hand Hygiene Recommendations and Glove Use and to Reduce the Incidence of Antimicrobial Resistance
149 Citations2007William E. Trick, Michael O. Vernon +5 more
A multimodal intervention program increased adherence to hand hygiene recommendations, especially to the use of alcohol-based hand rubs during a 3-year period, and a concomitant reduction was found in the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures.
Infection ControlIncreasing Handwashing in an Intensive Care Unit
146 Citations1986Joni A. Mayer, Patricia M. Dubbert +3 more
The first systematic evaluation of strategies for increasing handwashing of hospital staff was provided, and when feedback was provided on the experimental ICU, handwashing following completed patient contacts increased to 92%, and was significantly higher than handwashing on the control unit.
Patient Education and CounselingImproving patient and provider communication: A synthesis and review of communication interventions
114 Citations1991Lynda A. Anderson, Patricia A. Sharpe
Calculation of effect sizes (ES) offered a method for comparing the impact of these interventions on communicative behaviors and the dearth of studies examining interpersonal processes prevented drawing any conclusive statements about their relative efficacy.
Medical Care Research and ReviewReviewArticle: Effectiveness of Patient Care Teams and the Role of Clinical Expertise and Coordination
109 Citations2009Marije Bosch, Marjan J. Faber +6 more
It is concluded that enhancement of the clinical expertise is a potentially effective component of improving the impact of patient care teams and the added value of coordination functions remained unclear.
American Journal of Critical CareHand Hygiene Behavior in a Pediatric Emergency Department and a Pediatric Intensive Care Unit: Comparison of Use of 2 Dispenser Systems
109 Citations2005Elaine Larson, Sandra S. Albrecht +1 more
The touch-free dispensers were used significantly more often than were the manual dispensers and the type of dispensing system influenced hand hygiene behavior, but overall hand hygiene compliance remained low.
Journal of Hospital InfectionPrevalence of nosocomial infections in France: results of the nationwide survey in 1996
102 Citations2000The French Prevalence Survey Study Group
Journal of Clinical NursingThe use of a ward‐based educational teaching package to enhance nurses' compliance with infection control procedures
101 Citations1997Dinah Gould, Angela Chamberlain
The feasibility of using a ward-based teaching package to enhance nurses' compliance with key infection control precautions was tested in a quasi-experimental research study conducted on matched surgical wards in a teaching hospital.
Infection Control and Hospital EpidemiologyUse of an Alcohol-Based Hand Rub and Quality Improvement Interventions to Improve Hand Hygiene in a Russian Neonatal Intensive Care Unit
99 Citations2003Samuel M. Brown, Anna V. Lubimova +6 more
HH may have increased slightly, but the largest effect was a switch from soap and water to alcohol, which may have been associated with decreased cross-transmission of Klebsiella, although this may have be confounded by lower device use.
The Pediatric Infectious Disease JournalDecreasing Hospital-Associated Rotavirus Infection
99 Citations2005Danielle M. Zerr, Amanda L. Allpress +3 more
A hospital supported, house-wide campaign to improve hand hygiene and decreasing hospital-associated rotavirus infection rates was implemented, with results that can be useful for development of interventions aimed at improving hand hygiene.
Journal of Hospital InfectionPrevalance of and risk factors for hospital-acquired infections in Slovenia—results of the first national survey, 2001
98 Citations2003Irena Klavs, T Bufon Lužnik +8 more
The results provide the first national estimates for Slovenia of all types of hospital-acquired infections (HAIs) and to identify predominant micro-organisms and risk factors.
Infection Control and Hospital EpidemiologyEffect of an Automated Sink on Handwashing Practices and Attitudes in High-Risk Units
97 Citations1991Elaine Larson, Allison McGeer +5 more
Automated devices must be flexible enough to allow adjustments based on staff acceptance and application of new technology to improve hand hygiene requires a multifaceted approach to behavior change.
Journal of General Internal MedicineThe Influence of Information Technology on Patient-Physician Relationships
96 Citations2006Michael Weiner, Paul Biondich
Increased collaboration between experts in IT and relationship-centered care is needed, along with inclusion of relationship-based measures in informatics research, and information technology must be implemented in ways that preserve and uplift relationships in care.
Infection Control and Hospital EpidemiologyCompliance with Hand Hygiene and Glove Use in a University-Affiliated Hospital
93 Citations2005Nevin Kuzu, Fadime Gök Özer +3 more
Compliance with handwashing was low, suggesting the need for new motivational strategies such as supplying feedback regarding compliance rates, which was better in dirty high-risk situations.
BMJHand washing
89 Citations1999Handwashing Liaison Group
The failure of healthcare workers to decontaminate their hands reflects fundamentals of attitudes, beliefs, and behaviour, and there are no simple solutions.
Journal of Hospital InfectionHandwashing in healthcare workers: accessibility of sink location does not improve compliance
87 Citations2004Michael Whitby, Mary‐Louise McLaws
Improved accessibility to sinks does not lead to an improvement in healthcare workers' handwashing compliance, and glove use was shown to diminish compliance with handwashing protocols by as much as 25%.
Academic Emergency MedicineIs Handwashing Teachable?: Failure to Improve Handwashing Behavior in an Urban Emergency Department
81 Citations1996Steven Dorsey, Rita K. Cydulka +1 more
Despite a trend in improvement of compliance with CDC recommendations, handwashing among ED personnel remained unacceptably low.
Journal of Hospital InfectionPrevalence study of hospital-acquired infections in 14 Greek hospitals: planning from the local to the national surveillance level
80 Citations2002Achilleas Gikas, John Pediaditis +10 more
The aim of this project was to organize a surveillance of HAI with the participation of the greatest possible number of Greek hospitals, transferring the experience from the local Cretan infection control network in an effort to create a nationwide network.
American Journal of Infection ControlUsing peer feedback to improve handwashing and glove usage among Thai health care workers
80 Citations2000Wanchai Moongtui, Dorothy K. Gauthier +1 more
The PFP was effective during the intervention period, but there was no retention of effect, therefore, adjunct methods should be sought to promote retention ofEffect.
International Journal of Nursing PracticeThe effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit
78 Citations2008Wilawan Picheansathian, Alan Pearson +1 more
It is indicated that multiple approaches and persistent encouragement are key factors leading to a sustained high level of appropriate hand hygiene practices among nursing personnel.
Critical Care MedicineThe role of gown and glove isolation and strict handwashing in the reduction of nosocomial infection in children with solid organ transplantation
76 Citations2001Margaret Slota, Michael Green +3 more
Increased compliance with handwashing was associated with a reduction in nosocomial infections, and gown and glove isolation appeared to have an additional protective effect in the pediatric solid organ transplantation population.
Clinical Infectious DiseasesControl of Nosocomial Infections in an Intensive Care Unit in Guatemala City
76 Citations1995D. Berg, Ronald C. Hershow +2 more
General improvements in hygiene and hand washing rates, or even implementation of a closed urinary drainage system without focused education, may not be sufficient to reduce infection rates in intensive care units in developing countries.
The Journal of Continuing Education in NursingChanging Knowledge, Behavior, and Practice Related to Universal Precautions Among Hospital Nurses in China
76 Citations2002Jin Huang, Dong-ju Jiang +5 more
Although educational training significantly improved Chinese nurses' knowledge, practice, and behavior related to universal precautions, there remains room for improvement in glove use and needlestick injury reporting.
Journal of Hospital InfectionThe Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot
73 Citations2003Mary‐Louise McLaws, Peter Taylor
The pilot highlighted that the collection of data for aggregation of some procedures and intravascular catheters may take many years before a reliable benchmark can be identified and many hospitals may not achieve reliable local rates annually.
Journal of General Internal MedicineUsing the Six Sigma Process to Implement the Centers for Disease Control and Prevention Guideline for Hand Hygiene in 4 Intensive Care Units
73 Citations2006Noel Eldridge, Susan Woods +13 more
Journal of General Internal MedicineUsing the six sigma process to implement the centers for disease control and prevention guideline for hand hygiene in 4 intensive care units
68 Citations2006Noel Eldridge, Susan Woods +13 more
The Six Sigma process was effective for organizing the knowledge, opinions, and actions of a group of professionals to implement the CDC’s evidence-based hand hygiene practices in 4 ICUs.
Clinical Infectious DiseasesThe Impact of Gown-Use Requirement on Hand Hygiene Compliance
65 Citations2006Yoav Golan, Shira Doron +12 more
The hypothesis that a gown-use requirement might improve hand hygiene Compliance in the intensive care unit could not be confirmed and improvement in hand hygiene compliance associated with the gown- use requirement was small and did not affect precare rates.
CHEST JournalHand Washing and Use of Gloves While Managing Patients Receiving Mechanical Ventilation in the ICU
59 Citations1999Mohamad El Khatib, Ghassan Jamaleddine +2 more
Simple measures such as the placement of warning labels on mechanical ventilators can significantly improve hand washing and use of gloves by RCPs in the ICU.
Infection Control and Hospital EpidemiologyControlled Trial Measuring the Effect of a Feedback Intervention on Hand Hygiene Compliance in a Step-Down Unit
57 Citations2008Alexandre R. Marra, Cláudia D’Arco +11 more
The feedback intervention regarding hand hygiene had no significant effect on the rate of compliance and other measures must be used to increase and sustain the rates of hand hygiene compliance.
Journal of PerinatologyEffect of an Evidence-Based Hand Washing Policy on Hand Washing Rates and False-Positive Coagulase Negative Staphylococcus Blood and Cerebrospinal Fluid Culture Rates in a Level III NICU
55 Citations2002Paul J. Sharek, W.E. Benitz +4 more
Implementation of an evidence-based hand washing policy resulted in a significant increase in hand washing compliance and a significant decrease in false-positive coagulase negative staphylococcal blood and CSF culture rates.
Academic Emergency MedicineImpact of Wearable Alcohol Gel Dispensers on Hand Hygiene in an Emergency Department
55 Citations2008Janet P. Haas, Elaine Larson
These results support other studies in which only transient success was reported with a single intervention; greater success in sustaining increased HH compliance has been reported with use of multimodal approaches in which increased availability of products may be a part of the intervention.
Journal of Hospital InfectionPreventing nosocomial infections: improving compliance with standard precautions in an Indonesian teaching hospital
52 Citations2006D. Offra Duerink, Helmia Farida +6 more
Compliance with hand hygiene procedures improved significantly due to an intervention project focused on education and improved facilities, and compliance with safe handling of needles improved slightly due to introduction of the one-handed method for safe recapping of used needles.
AJN American Journal of NursingImproved Rates of Compliance with Hand Antisepsis Guidelines
46 Citations2001Melissa L. Earl, Marguerite M. Jackson +1 more
Hand antisepsis is arguably the single most effective means of preventing and controlling nosocomial infection, yet it's often neglected, although Nosocomial infections threaten the lives of approximately two million patients in the United States annually.
Infection Control and Hospital EpidemiologyHand Hygiene Compliance Rates After an Educational Intervention in a Neonatal Intensive Care Unit
46 Citations2007Craig H. Raskind, Sarah Worley +2 more
An observational study was performed at a level III neonatal intensive care unit to assess the impact of a hand hygiene promotion educational program on rates of compliance with hand hygiene on entrance into the unit.
The American Journal of the Medical SciencesImproving Handwashing Habits in the Newborn Nurseries
45 Citations1991Tonse N.K. Raju, Carole Kobler
The authors conclude that in the newborn units, the compliance with handwashing is generally poor and believe that with continued monitoring and educational efforts, it may be possible to improve habits regarding handwashing prophylaxis.
Infection Control and Hospital EpidemiologyAssessment of Healthcare Professionals' Adherence to Hand Hygiene After Alcohol-Based Hand Rub Introduction at an Intensive Care Unit in São Paulo, Brazil
43 Citations2007Solange L. Santana, Guilherme Henrique Campos Furtado +2 more
The impact of introducing an alcohol-based hand gel and an educational program on hand hygiene adherence among healthcare workers in an intensive care unit was significantly higher after the intervention for the night shift work period.
Australian Critical CareMaximising handwashing rates in the critical care unit through yearly performance feedback
41 Citations2000Thea van de Mortel, Robyn Bourke +5 more
It is demonstrated that feedback on handwashing performance by health care workers should be repeated within 12 months in order to maximise handwashing rates with the minimum intervention.
Clinical Nursing ResearchHealth Care Workers’ Hand Decontamination Practices
34 Citations2006Sile A. Creedon
A significant shift occurred in health care workers’ compliance with handwashing guidelines following the interventional hand-hygiene program and significant changes were also found in relation to health care Workers’ attitudes, beliefs, and knowledge.
American Journal of Infection ControlDoes a bed rail system of alcohol-based handrub antiseptic improve compliance of health care workers with hand hygiene? Results from a pilot study
27 Citations2008Efthymia Giannitsioti, S. Athanasia +9 more
The bed-rail approach initially improved HCWs' compliance with AHRA but did not radically influence behavior in internal medicine settings, and multidisciplinary strategies are required to establish hand hygiene recommendations.
Australian Critical CarePerformance Feedback Increases the Incidence of Handwashing by Staff Following Patient Contact in Intensive Care
27 Citations1995Thea van de Mortel, Louise Heyman
There was a trend towards an increased frequency in handwashing in all groups after performance feedback, but the differences were only statistically significant in the VMO and physiotherapist groups.
InfectionA Simple Effective Clean Practice Protocol Significantly Improves Hand Decontamination and Infection Control Measures in the Acute Surgical Setting
26 Citations2008D. Howard, Craig Williams +6 more
The introduction of the CPP significantly improved compliance of hand decontamination, correct usage of gloves and aprons, and overall infection-control in a large teaching hospital.
Implementation ScienceHelping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses
25 Citations2011Anita Huis, Lisette Schoonhoven +5 more
Evaluating the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses will be able to define a preferred implementation strategy for hospital based nursing.
Infection Control and Hospital EpidemiologyMulticenter Study of the Prevalence of Nosocomial Infections in Italian Hospitals
22 Citations2004Carlo Di Pietrantonj, Lorenza Ferrara +1 more
A point-prevalence study of nosocomial infections was conducted in 10 generai hospitals in northwestern Italy in June and July 2000 and foundUrinary tract infections were most frequent, accounting for 57.8% of 128 nosocomials infections.
…