O075: Successful implementation of the World Health Organization hand hygiene improvement strategy in a teaching hospital, China

Abstract

Introduction: Although hand hygiene is the most effective measure for preventing health care -associated infections, overall compliance of hand hygiene is poor in developing countries, and it is hard to promote HH by using WHO multi-strategy. Objectives: To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a 4300 beds hospital, a resource-poor area in China. Methods: A multi-prong approach was used in designing the hand hygiene program. The intervention consisted of rebuild hand-sinks; introducing a locally produced, self-branded alcohol-based handrub(ABHR); use the liquid soap take the place of solid soap; training and educating staff, students and patients through infection control week and World Hand Hygiene Day; monitoring hand hygiene compliance and the usage of ABHR and liquid soap, providing performance feedback; posting reminders in the workplace; and promoting an institutional safety climate according to the WHO multimodal hand hygiene improvement strategy. Results: All the hand-sinks were rebuild and hand-actuated taps were replaced. One self-branded ABHR has been produced with the cooperation of local manufacturers using the hand rub formulation provided by WHO. At follow-up, the usage of ABHR increased from 2.17(2009) to 12.28(2012) L per 1000 patient-days. And the compliance of hand hygiene increased from 45.9%(in Jan 2012) to 67.9% (in Dec. 2012). Improvement was observed across all professional categories. Healthcare-associated MRSA infection were reduced from 0.21( in January 2012) to 0.06(in Dec 2012) per 1000 patient-days. Conclusion: Multimodal hand hygiene improvement strategy is feasible and effective in a big teaching hospital in developing country. Leadership's support of the program and the active participation of staff is the key factor in helping to make the program a true success. The WHO multimodal inventions work in improving compliance and reducing healthcare associated infections.