A Multimodal Interventional Strategy To Increase Hand Hygiene Compliance In Intensive Care Unit Of A Tertiary Care Hospital In South India

Objective: Health care associated infections (HAIs) are major threat to patient safety in a hospital. Inadequate hand hygiene (HH) practice plays a very important role in transmission of HAIs. Material and Methods: The present study was a prospective interventional study, divided into 3 phases: pre-intervention, intervention phase, and post-intervention. A total of 40 HCWs, including doctors, nurses, and cleaning staff had given consent to participate in the study. Using standard formulas HH complete adherence rate (HHCAR), HH partial adherence rate (HHPAR), and HH total adherence rate (HHTAR) were calculated. Statistical analysis: The variables such as HHCAR, HHPAR and HHTAR were expressed in proportion (frequency and percentage). Comparison of HHCAR, HHPAR and HHTAR between the pre-intervention and post-intervention phases was carried out using appropriate statistical test such as the chi square or Fisher exact test. Profession-specific, moment-specific, shift and gender-specific HH compliances were compared using the χ2 test or Fisher exact test, using Epi Info software (version 6). For the questionnaire-based study, the same statistical tests were also used for comparison of knowledge between pre- and post-intervention phases. All statistical analyses were carried out at a 5% level of significance, and p values less than 0.05 was regarded to be statistically significant. Results: HHCAR, HHPAR, and HHTAR were estimated to be 18.03%, 49.53%, 67.57% respectively. HHCAR in the pre-intervention and post-intervention phases were 2.4% and 22.37%, respectively, reflecting a significant improvement in HH compliance (P<.001); whereas the improvement in HHPAR was found to be marginal, from 46.16% in the pre-intervention phase to 50.46% in the post-intervention phase. The HHTAR significantly improved to 72.83% in post intervention phase from 48.58 in pre-intervention phase. Conclusion: The present study demonstrated a statistically significant improvement in HH compliance following a multimodal educational intervention in the neurosurgery ICU of a tertiary care hospital.