BACKGROUND There is only limited understanding of why hand hygiene improvement strategies are successful or fail. It is therefore important to look inside the 'black box' of such strategies, to ascertain which components of a strategy work well or less well. This study examined which components of two hand hygiene improvement strategies were associated with increased nurses' hand hygiene compli...

In order to keep this guide easy to follow, we have refrained from describing the theoretical background and the statistical analysis techniques in detail. Instead we suggest step-by-step activities intended to solve a fictional but highly plausible problem—low compliance in hand hygiene behavior of resident physicians working in the Intensive Care Units (ICUs) of a hospital (see Box 1). Introd...

The purpose of hand hygiene is to break the chain of healthcare-associated infection. In many countries hand hygiene is regularly audited as part of quality assurance based on recommendations from the World Health Organization. Direct observation is the recommended audit method but is associated with disadvantages, including potential for being observed to alter usual behaviour. The Hawthorne e...

This study was a cross-sectional descriptive survey of acute care hospitals in California to describe staff hand hygiene compliance and related predictors and explore the relationship between hand hygiene adherence and health care-associated infections. Although there was a relatively small sample size, institutions with morning huddles reported a significantly higher proportion of 95% or more ...

To the editor: It was recently reported that influenza A was cultured in 62 double rooms at the Wisconsin Veterans Home over six seasons. The roommate was infected in 12 (19.4%). During 3,294 resident-seasons, influenza was cultured in 208 single rooms (6.3%). Those who lived in double rooms with a culture-positive roommate had a 3.07 relative risk (95% confidence interval51.61–5.78) of acquiri...

OBJECTIVE Valid and reliable instruments to measure aspects of hand hygiene are needed to determine the current situation and impact of training among health professionals. The main objective of this study was to describe the development of a questionnaire on hand hygiene among health professionals and to analyze the properties of this instrument. METHOD A questionnaire was designed and imple...

BACKGROUND Quality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees. METHODS The Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012. PS dimension scores were compared across learning settings...

BACKGROUND Many studies have examined hand hygiene (HH) frequency and adherence in response to various interventions. This study used 2 methods to determine HH frequency and adherence to see how well the outcomes correlated. METHODS HH frequency was measured over 4, 1-month periods (phases 1-4), using 2 methods: an audit of HH solution used during each phase adjusted for patient-days and cove...

Many studies have evaluated bundled interventions to improve hand hygiene compliance. However, there are few evidence-based recommendations on optimal interventions for implementation. We aimed to systematically review all studies on interventions to improve hand hygiene compliance to evaluate existing bundles and identify areas of promise to target high-quality studies. Adjusted risk ratios we...