UBC Faculty Research and Publications

Interventions to Improve Patient Hand Hygiene : A Systematic Review Srigley, Jocelyn A.; Furness, Colin D.; Gardam, Michael


Background: Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HAIs). Aim: To determine the efficacy of patient hand hygiene interventions in reducing HAIs and improving patient hand hygiene rates compared to usual care. Methods: We conducted a systematic review. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Findings: Ten studies were included, most of which were uncontrolled before-after studies (n=8). The majority of interventions (n=7) were multimodal, with components similar to healthcare worker hand hygiene programs, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HAI outcomes and 4 studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. Conclusion: Interventions to improve patient hand hygiene may reduce the incidence of HAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes.

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