Several studies have demonstrated a temporal relationship between improved hand hygiene practices and a reduction in HAI incidence and multidrug resistant microorganisms [2], [25]; however, few have been able to sustain a lasting impact [2], [26]. This finding led us to introduce alcohol-based hand rubs, and implement a hospital-wide program promoting hand hygiene through using alcohol-based hand rubs. Advantages – less water usage, your clothes stay better for longer (Yes it is true, washers literally beat your clothes to death and then we put them in dryers which in all seriousness literally break the fibers in your clothes apart), you get arm muscles (this is not a joke, if you think it is…..try handwashing for a day, washing your own clothes you will also get belly and back muscles! Frequent hand-washing is standard advice for avoidance of respiratory tract infections, but the evidence for a preventive effect in a general community setting is sparse. The price year was 2007. ... even with its limitations, that using hand sanitizer can remove the flu virus, but it took much longer than hand-washing did. Conceived and designed the experiments: YCC WHS JTW HCL. The number of expected episodes of HAI averted by the program was derived using the generalized autoregressive Poisson regression model. Heterogeneity factors were calculated by dividing the deviance with the degrees of freedom, and used as an indicator to assess whether an extra-Poisson variation (overdispersion) was present. There was an extensive description of the programme. Indications for Hand Hygiene. The program was reviewed, revised, and promoted annually according to the plan-do-check-act cycle [8]. Compliance with hand hygiene is the ratio of the number of performed actions using correct technique to the number of opportunities [2], [11]. We simulated germs with UV gel to show you the difference between washing your hands, and washing your hands properly. Panel B shows significant increases in the annual consumption of alcohol-based hand rub (p = 0.001), antiseptics (p = 0.04), and liquid soap (p = 0.03). However, one of these We measured the overall HAI rates, HAI rates by site of infection, and HAI rates by selected pathogen to assess the effectiveness of HHP. Promotion of the programme was by lectures and/or web-based self-learning with a post test, reminders located near points of care, use of hand hygiene compliance as a quality indicator, observation and verbal reminder by infection control nurses, periodic audits and performance feedback provided to units and departments, and incentives and fines for outstanding performance or failures. Study groups were not well balanced at baseline due to statistically significant differences in number of patient-days, comorbidity index and frequency of underlying comorbidities. The patient population, bed occupancy rate, age, gender, severity of underlying diseases, length of hospital stay, cumulative incidence of HAI, and outcome at discharge were determined during the preintervention (January 1999 to March 2004) and intervention (April 2004 to December 2007) periods. Prospective, hospital-wide on-site surveillance of HAIs at NTUH began in 1981, and were conducted through weekly visits from full-time ICN to all patient units [6]. values from the full and most parsimonious segmented regression models predicting monthly incidence density (episodes per 1000 patient-days) over time. Apply enough soap to cover your hands. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Hand hygiene compliance was assessed by direct observation during day shifts (8 a.m. to 5 p.m.) on weekdays according to the U.S.A. CDC criteria [10], using a standardized case report form. 2C. Finally, no significant change in the trends or levels of infections caused by MSSA and E. coli during the intervention period was observed, as shown in Fig. Thus, evaluation of the longitudinal effect of a hospital-wide hand hygiene program is only feasible in limited healthcare settings. This method requires data of the continuous or counted outcome measures, summarized at regular, evenly spaced intervals. The issue of uncertainty was partly addressed with univariate sensitivity analysis. For people who find that soap causes skin irritation, it is useful to note that soaps can have a different pH – they may be neutral, slightly alkaline or slightly acidic, and perfumes in soap may also cause irritation. The spread of bacterial eye infections, such as trachoma, can be reduced through regular hand washing. The rationale for the selection of comparators was clear as the hand hygiene programme was compared against the conventional pattern of care before implementation of the programme. Hand hygiene was identified as the core component of this strategy because it is a simple, standardized, low-cost measure based on solid scientific evidence. Facing an increase in overall HAIs and infections caused by multidrug-resistant organisms [6], the goal of this initiative was to decrease HAIs by blocking the transmission of microorganisms via the hands of healthcare workers (HCW). https://doi.org/10.1371/journal.pone.0027163.s002. However, when savings from future costs associated to healthcare-associated infection were considered the programme was dominant (more effective and less expensive). No significant changes in the respiratory tract and gastrointestinal tract infection rates were observed during the intervention. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan, For more information about PLOS Subject Areas, click Contributed reagents/materials/analysis tools: LYH. To use hand sanitizer correctly, apply the specified amount as directed by the product's label to the palm of one hand, and rub the sanitizer thoroughly over both hands until they feel dry. No, Is the Subject Area "Taiwan" applicable to this article? Additionally, the authors are grateful to Prof. Calvin Kunin and Prof. Wei-Chuan Hsieh for their suggestions and critical review of the manuscript. The hand hygiene program was announced and promoted hospital-wide for one month every year while preparing for pandemic influenza (typically during November). The site audit period was announced, though healthcare workers were not informed of the specific observation time. The overall improvement in hand hygiene compliance was significantly correlated with the increased consumption of alcohol-based hand rub (correlation coefficient r = 0.9399, p = .005), but less correlated with the consumption of antiseptics (r = 0.7930, p = .06) and soap (r = 0.7686, p = .07). Our recent survey demonstrated that the HH rate for 5 moments was only approximately 60%; whereas the HH rate for two moments exceeded 90% (unpublished data). Compliance was measured by direct observation and the use of hand rub products. Promotion consisted of lectures and/or web-based self-learning with a post test, reminders located near points of care, use of hand hygiene compliance as a quality indicator, observation and verbal reminders by infection control nurses, periodic audits and performance feedback provided to units and departments, and incentives of US$160.00 for an outstanding performance (unit and department level). Yes Whether these findings were relevant for other settings was unclear. The cost-effectiveness of the program was evaluated by calculating the extra cost required to prevent one episode of HAI from a hospital perspective. However, alcohol-based hand rubs were unavailable. We therefore set out to quantify, in a population-based adult general population cohort, the possible protection against acute respiratory tract infections (ARIs) conferred by a person’s self-perceived hand-washing frequency. A generalised autoregressive Poisson regression analysis was applied to identify the impact of the intervention on the outcome measure. It all depends on your environment and what are you doing throughout the day. Six surveys were conducted during the implementation period. The economic impact was estimated based on a case-control study in Taiwan. This type of washing machine is up to 24 inches in width making it great for small spaces such as in a small condo or apartment. The CDC advises that this process, much like hand washing, should take 20 seconds. No, Is the Subject Area "Epidemiology" applicable to this article? Well, washing your hands too much can hurt your skin, but a that can be remedied with hand lotion. This enabled us to determine the differences in HAI incidences over 4-year preintervention and postintervention periods, and conduct numerous observations while adjusting to changes in the frequency and severity of underlying diseases. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan, We decided to focus first on compliance with hand hygiene. (2011) Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing Healthcare–Associated Infections. We found that of the 226 opportunities presented, hospital staff washed their hands for only 16.6%. https://doi.org/10.1371/journal.pone.0027163.g001. 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