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Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe

Part of: WILLIAM JARVIS AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Victor D. Rosenthal ,
Mandakini Pawar ,
Hakan Leblebicioglu ,
Josephine Anne Navoa-Ng ,
Wilmer Villamil-Gómez ,
Alberto Armas-Ruiz ,
Luis E. Cuéllar ,
Eduardo A. Medeiros ,
Zan Mitrev  and
Achilleas Gikas
...Show all authors
Victor D. Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Mandakini Pawar
Affiliation:
Pushpanjali Crosslay Hospital, Ghaziabad, India
Hakan Leblebicioglu
Affiliation:
Ondokuz Mayis University Medical School, Samsun, Turkey
Josephine Anne Navoa-Ng
Affiliation:
St. Luke's Medical Center, Quezon City, Philippines
Wilmer Villamil-Gómez
Affiliation:
Clínica Santa María, Sucre, Colombia
Alberto Armas-Ruiz
Affiliation:
Centro Médico La Raza IMSS, Mexico City, Mexico
Luis E. Cuéllar
Affiliation:
Instituto Nacional de Enfermedades Neoplásias, Lima, Peru
Eduardo A. Medeiros
Affiliation:
Hospital São Paulo, São Paulo, Brazil
Zan Mitrev
Affiliation:
Special Hospital for Surgical Disease “Filip Vtori, ” Skopje, Macedonia
Achilleas Gikas
Affiliation:
University Hospital of Heraklion, Heraklion, Greece
Yun Yang
Affiliation:
Shanxi Dayi Hospital, Tai Yuan, China
Altaf Ahmed
Affiliation:
Indus Hospital, Karachi, Pakistan
Souha S. Kanj
Affiliation:
American University of Beirut Medical Center, Beirut, Lebanon
Lourdes Dueñas
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
Vaidotas Gurskis
Affiliation:
Pediatric Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania
Trudell Mapp
Affiliation:
Clínica Hospital San Fernando, Panama City, Panama
Humberto Guanche-Garcell
Affiliation:
Hospital Docente Clínico Quirúrgico “Joaquín Albarrán Domínguez, ” Havana, Cuba
Rosalía Fernández-Hidalgo
Affiliation:
Hospital Clínica Bíblica, San José, Costa Rica
Andrzej Kübler
Affiliation:
University Hospital of Wroclaw, Wroclaw, Poland
*
International Nosocomial Infection Control Consortium (INICC), Corrientes Ave No. 4580, Floor 12, Apt. D, Buenos Aires 1195, Argentina (victor_rosenthal@inicc.org, http://www.inicc.org)
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Abstract

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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 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P<.001), physicians versus nurses (62% vs 72%; P<.001), and adult versus neonatal ICUs (67% vs 81%; P<.001), among others.

Conclusions.

Adherence to hand hygiene increased by 48% 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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 4 , April 2013 , pp. 415 - 423
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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