Infection prevention promotion program and hand hygiene behaviours


Intravenous literature: Aboumatar, H., Ristaino, P., Davis, R.O., Thompson, C.B., Maragakis, L., Cosgrove, S., Rosenstein, B. and Perl, T.M. (2012) Infection Prevention Promotion Program Based on the PRECEDE Model: Improving Hand Hygiene Behaviors among Healthcare Personnel. Infection Control and Hospital Epidemiology. 33(2), p.144-151.


Background – Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor.

Objective – To assess short- and long-term effects of an infection prevention promotion program on healthcare personnel hand hygiene behaviors.

Design – Time series design.

Setting – Our study was conducted at a tertiary care academic center.

Participants – Hospital healthcare personnel.

Methods – We developed a multimodal program that included a multimedia communications campaign, education, leadership engagement, environment modification, team performance measurement, and feedback. Healthcare personnel hand hygiene practices were measured via direct observations over a 3-year period by “undercover” observers.

Results – Overall hand hygiene compliance increased by 2-fold after full program implementation (), and this increase was sustained over a 20-month follow-up period (). The odds for compliance with hand hygiene increased by 3.8-fold in the 6 months after full program implementation (95% confidence interval, 3.53–4.23; ), and this increase was sustained. There was even a modest increase at 20 months of follow up. Hand hygiene compliance increased among all disciplines and hospital units. Hand hygiene compliance increased from 35% in the first 6 months after program initiation to 77% in the last 6 months of the study period among nursing providers (), from 38% to 62% among medical providers (), and from 27% to 75% among environmental services staff ().

Conclusions – Implementation of the infection prevention promotion program was associated with a significant and sustained increase in hand hygiene practices among healthcare personnel of various disciplines.

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