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

Abstract

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 patientdays 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.