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Results of 3 National hand hygiene campaigns in Belgian hospitals 2005-2009

Results of 3 National hand hygiene campaigns in Belgian hospitals 2005-2009. Eva Leens, Anne Simon et le groupe de travail. « Vous êtes en de bonnes mains ». Methodology. Awareness campaign with standardised material to improve HH compliance Measuring impact of the campaign

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Results of 3 National hand hygiene campaigns in Belgian hospitals 2005-2009

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  1. Results of 3 National hand hygiene campaigns in Belgian hospitals2005-2009 Eva Leens, Anne Simon et le groupe de travail « Vous êtes en de bonnes mains »

  2. Methodology • Awareness campaign with standardised material to improve HH compliance • Measuring impact of the campaign • HH compliance (soap and/or alcool / HH opportunities) • Alcohol rub consumption (liter alcohol rub / 10000 patient days) • Respect of basic hygiene conditions (optional, only 3rd campaign)

  3. Planning 1 month later and for 1 month 1 month later and for 1 month 9 months later Post-campaign During 1 month 15/04-14/05 Invitation to participate + press conference Measurement of HH indicators Awareness Campaign Mea surement of HH indicators First campaign: 2005 Second campaign: 2006-2007 Third campaign: 2008-2009 National Feedback session

  4. Awareness campaign: multi modal • Reminders (posters) • Education of HCW • standardised powerpoint presentation • Interactive quiz • Distribution of gadgets for HCW or patients • Promotion of hand rub (posters, black light) • Implication of patients (leaflets, gadget) • Feedback of measurement results before and after campaign

  5. Campaign messages • First campaign: • Hand hygiene, just do it … and with alcohol rubs • Second campaign: • Hand hygiene, do it correctly • Third campaign: • Do not wear jewellery or artificial nails and keep your nails clean • Use gloves correctly

  6. Measurement of HH compliance • Direct (overt or covert) observation • By trained observers (IC practitioner or reference nurses for hospital hygiene) • Standardised observation grid (WHO proofed) • Observation period of 30 minutes, 24/24, 7/7 • Minimum 150 opportunities for HH per unit • At least intensive care units • Same methodology before and after campaign

  7. RESULTS

  8. N observed opportunities

  9. 1. HAND HYGIENE COMPLIANCE

  10. N hop n=148 n=127 n=178 n=158 n=168 n=145 69% 68% 69% 53% 58% 48% Distribution of average HH compliance +11% +16% +20%

  11. Base -line acute hosp: 50% HH compliance in psychiatric hospitals 70% 43% 70% 67% 58% 43%

  12. Hand hygiene compliance by profession

  13. Overall HH compliance by profession (all) 20%

  14. Evolution of HH compliancein nurses en physicians

  15. HH compliance by HH indication (all) 75% 60% 50% 33% Before campaign After campaign • Before contact with patient • Before clean/invasive action • After contact with patient • After biological liquids exposure • After contact with patient environment

  16. 27% HH compliance by indication +25% 75% 54% 50% +27% 27% 27% Before After After Before After Before

  17. 2. HAND RUB SOLUTION USE

  18. Proportion Alcool / Alcool + soap 78% 76% 76% 73% 67% 65%

  19. 3 OBSERVATION OF JEWEL AND NAILS • ( Basic requirements)

  20. Participation • Optionnal participation (3rd campaign)

  21. Impact of the campaign (all)

  22. Impact by institution category Long term care and psychiatric institutions Acute hospitals

  23. Impact on professionnal categories Ring Watch

  24. Nails

  25. Conclusions for basic requirements • Awareness campaign has a positif impact on jewels wearing and nails hygiene • Ring and /or watches wearing are the most frequent problems • Impact is variable depending on type of institutions and professionnal categories (chronic < acute) and (<< physicians) • Nails hygiene is good in 50% of the institutions • Students are the best !

  26. General conclusions: Campaigns were succesfull • High participation rate • Increase of HH compliance at short and long term • Alcohol rub is widely used  Key factors for succes: • Multi modal awareness campaign • Repetition of campaign • National implication • Political and financial support

  27. Antibiotic use management teams 1st Camp 2005 2d Camp 2006-2007 3d Camp 2008-2009 MRSA new guidelines

  28. Conclusions • Results: • HH compliance nurses > medical doctors • HH compliance after contact > before contact • Pre-campaign compliance still increases after 3 camp • Post-campaign compliance remains stable after 3 camp • Impact of the campaign on HH compliance decreases  Impact on content of 4th HH campaign

  29. Thank you for your attention!

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