Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review

Area of Science:

• Infection Prevention and Control
• Healthcare Quality Improvement
• Public Health

Background:

• Hand hygiene is recognized as the primary method for preventing healthcare-associated infections.
• Global compliance rates among healthcare workers remain suboptimal, a concern amplified by the COVID-19 pandemic.
• Effective strategies are needed to enhance hand hygiene practices in clinical settings.

Purpose of the Study:

• To systematically review clinical trials on hand hygiene interventions published between 2014 and 2020.
• To provide evidence-based recommendations for healthcare leaders and practitioners on reducing infections through improved hand hygiene.
• To synthesize current research on the effectiveness of various hand hygiene strategies.

Main Methods:

• A systematic literature search was conducted across major databases (CINAHL, Cochrane, EMbase, Medline, PubMed, Web of Science).
• Clinical trials focusing on hand hygiene compliance among healthcare workers from March 2014 to December 2020 were included.
• 57 studies were selected from an initial pool of 332 identified papers.

Main Results:

• Most studies (79%) were from Asia, Europe, and the USA, primarily in acute care settings.
• Nurses and physicians were the most frequently studied healthcare worker groups.
• The World Health Organization's multi-modal framework was commonly adopted, with recording of hand hygiene opportunities, but not technique, being frequent.

Conclusions:

• Both single interventions and multi-modal approaches can lead to modest to moderate improvements in hand hygiene compliance.
• Sustained efforts are necessary to optimize hand hygiene practices among healthcare professionals.
• Further research may be needed to explore effective methods for recording and improving hand hygiene technique.