Investigating Relationships Between Healthcare Worker Hand Hygiene and Healthcare-Associated Infections in Pediatric Populations: An Interventional Study

Healthcare-associated infections (HAIs) are a public health burden that contribute to significant morbidity, mortality, hospital stays, and healthcare costs. HAIs disproportionately affect certain groups who often require special infection prevention and control (IPC) considerations, such as immunocompromised, neonatal, and pediatric populations. Hand hygiene (HH) is the most effective strategy to reduce HAIs. Yet HH compliance among healthcare workers (HCWs) often does not meet recommended guidelines, necessitating education and interventions to increase adherence. This study assessed the impact of an HH campaign on HCW HH compliance and examined subsequent HAI incidence at a mid-size pediatric acute care hospital in the United States. The campaign used staff education, increased administrative oversight, and real-time HH compliance monitoring from overt and covert hand hygiene observers to determine HH adherence. To address HAI trends, patient data from electronic health records were compiled, analyzed, and used in HAI calculations. Pre-intervention baseline data was collected over a 3-month period and analyzed in comparison to 3-months of intervention and 2-months of post-intervention data. Upon completion of the post-intervention period, changes in HH compliance were compared to the shifts in incidence of HAIs. The results showed a significant whole-house increase in HH compliance, rising from a 79.8% pre-intervention compliance to a 93.7% compliance at the end of the post-intervention period. Highly trafficked and high-risk areas like the Emergency Department, the Rehabilitation Unit, and the Pediatric Intensive Care Unit increased in HH compliance. Subsequently, there was a decrease in whole-house HAIs, with a pre-intervention average rate of 4.45 and a post-intervention average rate of 3.18. Three out of eight examined HAI subtypes examined had average post-intervention period rates that were less than their pre-intervention rate. Findings from this HH campaign and HAI data analysis highlight the importance of targeted IPC interventions. The success of the intervention underscores the value of prioritizing HH and HH initiatives for healthcare workers and their patients’ health and safety. Outside of just reducing HAIs, HH provides a cost-effective measure that can reduce the strain on healthcare systems. This intervention reinforces the necessity of HH and IPC measurements to maintain and improve public health.