This article is more than 5 years old. Information may no longer be current.
Hand hygiene intervention bundles need further study
Bundled interventions improved hand hygiene compliance, but more research is necessary to identify the ideal bundle, according to data from a systematic review and meta-analysis.
“Hand hygiene is important in preventing transmission of [health care–acquired infections],” researchers from the University of Iowa wrote in Clinical Infectious Diseases. “However, current rates of hand hygiene compliance range from 5% to 81%, with an average compliance of approximately 40%.”
The review included 46 studies of hand hygiene interventions that were published from January 2000 to April 2012. Most of the studies were quasi-experimental and conducted in either Europe or the United States. The most common study location was the ICU (n=23), followed by acute care units (n=14). Most of the studies used direct human observation to measure compliance.
In most of the studies (78%), a bundle of more than one hand hygiene intervention was assessed. The most common interventions were education, reminders, feedback and access to alcohol-based hand rub. Bundles with a larger number of interventions did not increase hand hygiene compliance compared with bundles of one or two interventions. The following bundles were associated with improved hand hygiene compliance:
- Education, reminders, feedback, administrative support and access to alcohol-based hand rub;
- Education, reminders and feedback.
“Most studies (of these two bundles) were before-after quasi-experimental studies with a single pre-intervention historical control group and single post-intervention experimental group, lacking more robust quasi-experimental methods such as inclusion of a non-equivalent control group,” the researchers wrote. “This suggests a need for investments in additional high-quality research studies of interventions targeting hand hygiene compliance.”
Disclosure: The researchers report no relevant financial disclosures.