Alcohol-based hand rub consumption surveillance in German hospitals – latest results

Abstract

Introduction: HAND-KISS is a unit-based surveillance system of alcoholbased hand rub consumption (AHC). It is part of the German national nosocomial infection surveillance system (KISS). Objectives: We analyzed the development in AHC between 2007 to 2014. Methods: Participating hospitals transfer data on patient days and AHC per unit once a year to HAND-KISS. The system calculates the data as AHC in milliliter (ml) per patient day (PD) stratified by unit type (intensive care units [ICU] and non-ICU) and specialty (medical, surgical, pediatrics, neonatal etc.). The distribution of all participating wards are published annually as HAND-KISS reference data. To evaluate AHC changes over the years, we selected all hospitals and wards which continuously provided surveillance data over the whole period of 8 years. For all ICUs and non-ICUs we estimated the median AHC (interquartile range, IQR) for every year and compared the results. Results: 188 hospitals with 334 ICUs and 1,954 non-ICUs transferred AHC data for 2007 (645 hospitals, 890 ICUs and 6,063 non-ICUs for 2014[g1]). 101 hospitals with 130 ICUs and 760 non-ICUs continuously provided surveillance data over a period of 8 years. In 2007, the median AHC in the ICUs was 69 ml/PD (IQR, 52 ml/PD - 95 ml/PD), and in 2014 the result was 115 ml/PD (IQR, 84 ml/PD - 140 ml/PD) corresponding with an increase of 54%. The median AHC on non- ICUs was 15 ml/PD (IQR, 12 ml/PD - 18 ml/PD) in 2007 and 26 ml/PD (IQR 26 ml/PD - 32 ml/PD) in 2014 corresponding with an increase of 83%. The hospital-wide progression is 81%. Conclusion: HAND-KISS is widely accepted in Germany. It is an established benchmarking tool to characterize hand hygiene behavior in an individual hospital.