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Background: Hand hygiene (HH) is considered to be the most simple, rapid, and economic way to prevent health care–associated infection (HAI). However, poor HH compliance has been repeatedly reported. Our objective was to evaluate the impact of implementing the updated World Health Organization (WHO) multimodal HH guidelines on HH compliance and HAI in a tertiary hospital in Taiwan.

Methods: We conducted a before-and-after interventional study during 2010-2011. A multimodal HH promotion campaign was initiated. Key strategies included providing alcohol-based handrub dispensers at points of care, designing educational programs tailored to the needs of different health care workers, placement of general and individual reminders in the workplace, and establishment of evaluation and feedback for HH compliance and infection rates.

Results: Overall HH compliance increased from 62.3% to 73.3% after 1 year of intervention (P < .001). The rate of overall HAI decreased from 3.7% to 3.1% (P < .05), urinary tract infection rate decreased from 1.5% to 1.2% (P < .05), and respiratory tract infection rate decreased from 0.53% to 0.35% (P < .05). This campaign saved an estimated $940,000 and 3,564 admission patient days per year.

Conclusion: The WHO multimodal HH guidelines are feasible and effective for the promotion of HH compliance and are associated with the reduction of HAIs.


Chen, J-K., Wu, K-S., Lee, S.S-J., Lin, H-S., Tsai, H-C., Li, C-H., Chao, H-L., Chou, H-C., Chen, Y-J., Huang, Y-H., Ke, C-M., Sy, C.L., Tseng, Y-T. and Chen, Y-S. (2015) Impact of implementation of the World Health Organization multimodal hand hygiene improvement strategy in a teaching hospital in Taiwan. American Journal of Infection Control. December 13th. .


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