Hand hygiene-related clinical trials reported since 2010: a systematic review

Area of Science:

• Infection Control
• Public Health
• Clinical Research

Background:

• Healthcare-associated infections (HAIs) are a significant concern, with hand hygiene compliance among professionals being a key focus.
• Public perception and media discussions highlight concerns about existing hand hygiene practices in healthcare settings.

Purpose of the Study:

• To systematically review peer-reviewed clinical trials on hand hygiene compliance among healthcare professionals.
• To evaluate the effectiveness of different intervention strategies published after the World Health Organization (WHO) hand hygiene guidelines.

Main Methods:

• Systematic search of PubMed and CINAHL for literature published between December 2009 and February 2014.
• Inclusion of 16 clinical trials after assessing relevance and methodology from an initial retrieval of 57 publications.
• Analysis of studies focusing on 'hand hygiene opportunity' as the unit of analysis, with some adopting the WHO 'my five moments for hand hygiene' framework.

Main Results:

• The majority of reviewed studies were conducted in the USA and Europe, with intensive care units and elderly care facilities being predominant settings.
• Nurses were the most frequently studied healthcare worker group, followed by healthcare assistants and doctors.
• Multimodal intervention strategies, whether WHO-guided or other tested frameworks, demonstrated moderate improvements in hand hygiene compliance.

Conclusions:

• Multimodal approaches are effective in enhancing hand hygiene compliance among healthcare professionals.
• The adoption of structured frameworks, such as the WHO guidelines, contributes to successful intervention strategies.
• Continued focus on improving hand hygiene is crucial for reducing healthcare-associated infections.