Long-term effectiveness evaluation of an action-research intervention to improve hand hygiene in an intensive care unit

Abstract

Objectives: To evaluate the long-term effectiveness of an action research intervention aimed at improving hand hygiene in an intensive care unit of a public hospital in Italy.

Methods: An observational, prospective before-after study was carried out.Compliance with hand hygiene was estimated by measuring the utilization of hand hygiene products before the intervention and four years after the end of the project. Products used were the following: detergent liquid soap, antiseptic liquid soap and alcohol-based hand gel. Endpoints were quantity consumed (in grams) for each product category. Quantitative consumptions per workshift were compared.

Results: In 2017 the median consumption of antiseptic liquid soap and alcohol-based hand gel per workshift was significantly higher than in 2012 (111.5 g vs 72.5 g, p = 0.014, and 18.0 g vs 5.0 g, p < 0.001). Odds in favour of a higher value in 2017 were 1.99:1 (CI95%: 1.19:1 to 3.73:1) for antiseptic solution, and 5.39:1 (CI95%: 3.09:1 to 13.61:1) for antiseptic gel. Covariates were not associated with consumption of products, and this made it possible to compare the measurements in the two data collections.

Conclusions: Results of this study support the long-term effectiveness of the action research intervention to improve practices of hand hygiene in an intensive care setting.

Keywords: Action research; Effectiveness; Evaluation; Hand hygiene; Intensive care unit; Organisational change.