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Published on: June 7, 2017
Patient Hand Hygiene Before Meals: A Systematic Review
Ariel Kamen1, Rebecca Clark, Michelle B Bass
1Author Affiliations: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (Miss Kamen and Dr Clark); Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania (Miss Kamen, Drs Clark, Mull, and Mitchell); Pennsylvania Hospital, University of Pennsylvania Hospital System, Philadelphia, Pennsylvania (Drs Clark, Bass, Ms Fonshell); Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Drs Holland and Mull); Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (Dr O'Donnell); Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr O'Donnell) .
Patient hand hygiene (PHH) before meals is under-researched. Current evidence is insufficient to link PHH interventions to reduced healthcare-associated infections (HAIs), indicating a need for more studies.
Area of Science:
- Infection Prevention and Control
- Patient Safety
- Healthcare Epidemiology
Background:
- Hand hygiene is crucial for preventing healthcare-associated infections (HAIs).
- Patient hand hygiene (PHH) receives limited research focus.
- Understanding PHH is vital for comprehensive infection control strategies.
Purpose of the Study:
- To systematically review existing evidence on patient hand hygiene (PHH) performed before meals.
- To identify and categorize interventions promoting PHH.
- To summarize the reported outcomes associated with PHH interventions.
Main Methods:
- A systematic literature search was conducted across four databases.
- The review covered publications from 1999 to 2024.
- The Grading of Recommendations, Assessment, Development, and Evidence (GRADE) framework appraised evidence strength.
Main Results:
- Ten reports met the inclusion criteria for the review.
- Interventions for PHH included direct observation, reminders, education, policy changes, and bundled approaches.
- Insufficient evidence exists to confirm a direct causal relationship between pre-meal PHH and reduced HAIs.
Conclusions:
- A significant knowledge gap exists regarding patient hand hygiene (PHH).
- The current evidence base for PHH is limited to moderate.
- Further research is essential to establish the clinical efficacy and impact of PHH on HAIs in hospitalized patients.
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