Implementation and sustainment of a structured hand hygiene group in an oncology hospital: a key factor for improving...

Hand hygiene (HH) is central to infection prevention, but evidence from oncology hospitals - where patients are immunosuppressed and strict adherence is critical - remains limited. We aimed to describe the implementation and development of a HH group and its associated activities in an oncology hospital, as well as to evaluate their impact on HH compliance, alcohol-based hand rub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores.

This analysis examined long-term trends in HH performance in a tertiary oncology hospital in Brazil (2010-2024), using adherence, ABHR consumption, and HHSAF scores to assess the impact of a multi-modal programme. Trend analyses of HH adherence, ABHR consumption, and HHSAF scores over time were performed using linear regression.

After the HH group was established in 2013, the programme rapidly progressed to the advanced HHSAF level, accompanied by a significant upward trend in HH adherence (P < 0.01), increasing from a baseline of 26%-88% in 2022. In contrast, no significant trend was observed for ABHR consumption (P = 0.29), although levels remained consistently above the World Health Organization (WHO)-recommended threshold. System change was the strongest multi-modal component, whereas institutional safety climate remained the weakest.

Unlike most published studies focused on short-term campaigns or isolated interventions, our work evaluated the real-world sustainability of a WHO-based multi-modal programme implemented in routine hospital practice. Sustained improvement was driven by a permanent, structured, multi-disciplinary HH group, resulting in long-term advanced HHSAF performance with increasing trends in HH compliance.