What is the impact of simulation on hand hygiene compliance

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To evaluate how critical nurses’ knowledge of and adherence to current care hand hygiene (HH) guidelines differ between randomly allocated intervention and control groups before and after simulation education in both a simulation setting and clinical practice during a 2-year follow-up period” Jansson et al (2016).

Abstract:

Background: To evaluate how critical nurses’ knowledge of and adherence to current care hand hygiene (HH) guidelines differ between randomly allocated intervention and control groups before and after simulation education in both a simulation setting and clinical practice during a 2-year follow-up period. It was hypothesized that intervention group knowledge of and adherence to current HH guidelines might increase compared with a control group after simulation education.

Methods: A prospective, parallel, randomized controlled trial with repeated measurements was conducted in a 22-bed adult mixed medical-surgical intensive care unit in Oulu, Finland. Thirty out of 40 initially randomized critical care nurses participated in the baseline measurements; of these, 17 completed all the study procedures. Participants’ HH adherence was observed only in high-risk contact situations prior to and postendotracheal suctioning events using a direct, nonparticipatory method of observation. Participants’ HH knowledge was evaluated at the end of each observational session.

Results: The overall HH adherence increased from a baseline value of 40.8% to 50.8% in the final postintervention measurement at 24 months (P = .002). However, the linear mixed model did not identify any significant group (P = .77) or time-group interactions (P = .17) between the study groups after 2 years of simulation education. In addition, simulation education had no impact on participants’ HH knowledge.

Conclusions: After a single simulation education session, critical care nurses’ knowledge of and adherence to current HH guidelines remained below targeted behavior rates.

Reference:

Jansson, M.M., Syrjälä, H.P., Ohtonen, P.P., Meriläinen, M.H., Kyngäs, H.A. and Ala-Kokko, T.A. (2016) Simulation education as a single intervention does not improve hand hygiene practices: A randomized controlled follow-up study. American Journal of Infection Control. February 18th. [epub ahead of print].

DOI: http://dx.doi.org/10.1016/j.ajic.2015.12.030

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