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O076: Impact of the implementation of the who hand hygiene promotion strategy in the Hong Kong pilot site: 2006-2012

Introduction

The WHO First Global Patient Safety Challenge “Clean Care is Safer Care” aims to tackle healthcare-associated infection worldwide with hand hygiene (HH) as the cornerstone intervention.

Objectives

To assess the impact and sustainability of the WHO hand hygiene multimodal improvement strategy in the Hong Kong pilot site hospital.

Methods

Times series design with experimental and control wards. Data were collected during three cycles of action research targeted at improving compliance with practices.

Results

Overall hand hygiene compliance was 22% (experimental wards, 18.3%; controls, 25.4%) at baseline. At the end of the first action research cycle (April–Dec 2006), compliance improved to 41.6% in experimental wards and decreased to 18.8% in control wards. When multimodal interventions were extended to six study sites in the second action research cycle (Jan–May 2007), experimental wards showed sustainability (44.4%), while no change was observed in control wards (25.6%). During the last action research cycle (May 07– Feb 2008), overall compliance increased to 54% (experimental wards, 52.6%; controls, 55.3%). Further reinforcement strategies were implemented from March 2008 and overall hospital compliance increased to 78.6% in 2012. In parallel, the use of alcohol-based handrub increased from 2L/1000 patient-days in 2006 to 45L/1000 patient-days in 2012. Methicillin-resistant Staphylococcus aureus bloodstream infection decreased from 1.53/1’000 patient-days in 2006 to 0.87/1’000 patient-days in 2012.

Conclusion

The WHO HH promotion strategy, using an action research approach, is successful with sustained compliance and continuous reduction in MRSA bloodstream infection rates.

Disclosure of interest

None declared.

Author information

Correspondence to JWM Tai.

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Keywords

  • Bloodstream Infection
  • Hand Hygiene
  • Promotion Strategy
  • Hand Hygiene Compliance
  • Pilot Site