[Assessment of a hand hygiene program on healthcare-associated infection control]

to assess the impact of a hand hygiene campaign on the rate of healthcare-associated infections in a teaching hospital in Las Palmas.

Ecological design by hand hygiene frequency measurement at three high risk areas along with infection rates calculation over four periods of time: baseline (2005), phase 1 (2006), phase 2 (2007), and post-intervention (2008). Multi-modal intervention comprised the introduction of alcoholic solutions for rubbing hands, feedback on observed compliance, design and placement of posters, and healthcare workers training through all clinician areas. Variables measurement was carried out according to standardized criteria.

an increase in hand hygiene compliance was achieved over the tree periods of compliance surveillance, from 19.6% at baseline to 40.0% (p<0.001) at the last period. The increase was higher among those opportunities for hand hygiene considered as high risk for pathogen transmission (from 12.0% to 28.4%; p<0.001), but only after phase 1, and for medium risk opportunities. Infection rates did not low in every area under surveillance, especially prevalence of infected patients, which increased from 8% in 2005 to 12.2% in 2008.

Despite the increase in adherence to hand hygiene at the areas under surveillance, health-care associated infections were not lowered hospital-wide. A more comprehensive strategy should be implemented, increasing managers and directors support in every task related to infection control.