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Journal Article

Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel

Hanan Aboumatar MD MPH, Polly Ristaino MS CIC, Richard O. Davis PhD, Carol B. Thompson MS MBA, Lisa Maragakis MD MPH, Sara Cosgrove MD MS, Beryl Rosenstein MD and Trish M. Perl MD MSc
Infection Control and Hospital Epidemiology
Vol. 33, No. 2 (February 2012), pp. 144-151
DOI: 10.1086/663707
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Page Count: 8
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Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel
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Background. Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor.Objective. To assess short- and long-term effects of an infection prevention promotion program on healthcare personnel hand hygiene behaviors.Design. Time series design.Setting Our study was conducted at a tertiary care academic center.Participants. Hospital healthcare personnel.Methods. We developed a multimodal program that included a multimedia communications campaign, education, leadership engagement, environment modification, team performance measurement, and feedback. Healthcare personnel hand hygiene practices were measured via direct observations over a 3-year period by “undercover” observers.Results. Overall hand hygiene compliance increased by 2-fold after full program implementation (), and this increase was sustained over a 20-month follow-up period (). The odds for compliance with hand hygiene increased by 3.8-fold in the 6 months after full program implementation (95% confidence interval, 3.53–4.23; ), and this increase was sustained. There was even a modest increase at 20 months of follow up. Hand hygiene compliance increased among all disciplines and hospital units. Hand hygiene compliance increased from 35% in the first 6 months after program initiation to 77% in the last 6 months of the study period among nursing providers (), from 38% to 62% among medical providers (), and from 27% to 75% among environmental services staff ().Conclusions. Implementation of the infection prevention promotion program was associated with a significant and sustained increase in hand hygiene practices among healthcare personnel of various disciplines.

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