Interventions to improve compliance with hand hygiene practices

Added March 16, 2020

Citation: Gould DJ, Moralejo D, Drey N, Chudleigh JH, Taljaard M. Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews 2017; (9): CD005186.

What is this? The arrival of a new respiratory virus, such as COVID-19, is followed by a lead-time for the development of vaccines and treatments, and these may have a limited effect in containing or interrupting spread of the virus. Therefore, identifying and ensuring good practice in, for example, hand hygiene is important for interrupting or reducing its spread.

In this Cochrane systematic review, the authors searched for comparative effectiveness studies (randomized and non-randomized trials, controlled before-after studies and interrupted time series analysis) of interventions to improve the compliance of healthcare workers with hand hygiene practice. They did not restrict by language of publication and conducted their most recent searches in October 2016, identifying 26 eligible studies.

What works: Multimodal interventions using some or all of the WHO recommended strategies (alcohol based hand rub at point of care or carried by the healthcare worker, training and education, observation and performance feedback, reminders (e.g. posters) and administrative support) might slightly improve hand hygiene compliance and, in some cases, infection rates.

Introducing performance feedback, education or cues may improve hand hygiene compliance and reduce infection rates and colonization rates.

Placement of alcohol based hand rub close to point of use may improve hand hygiene compliance.

What doesn’t work: Nothing noted.

What’s uncertain: Whether many of the interventions have effects on infection rates is unclear.


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