title: Performance feedback of hand hygiene, using alcohol gel as the skin decontaminant, reduces the number of inpatients newly affected by MRSA and antibiotic costs.
abstract: In March 2000 the Plastic Surgery Unit of our 600-bedded district general hospital agreed to be the pilot ward for the introduction of a new standard of hand hygiene, emphasizing the use of alcohol gel on socially clean hands between clinical contact with patients. Hand hygiene practice of healthcare workers (HCWs) was observed using Formic forms. The data from completed forms were scanned into an Excel database, and results fed back to HCWs in graphical form. The case notes of patients newly affected by methicillin-resistant Staphylococcus aureus (MRSA), likely to have been acquired as inpatients, were reviewed for one year before and after this performance feedback of hand hygiene. The cost of teicoplanin use (for MRSA infections) was also determined for the two periods. There was a significant reduction in the number of patients newly affected by MRSA (P<0.05), and in the use of teicoplanin, suggesting that performance feedback of hand hygiene reduces nosocomial MRSA infection rates and antibiotic use.
authors.affiliation: The Lister Hospital, Stevenage, Hertfordshire, UK. alan.macdonald@aaaht.scot.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: MacDonald
authors.forename: F
authors.initials: F
authors.lastname: Dinah
authors.forename: D
authors.initials: D
authors.lastname: MacKenzie
authors.forename: A
authors.initials: A
authors.lastname: Wilson
mesh_terms: D000438:Alcohols / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000191:economics; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D003666:Decontamination / Q000379:methods*; D005782:Gels / Q000493:pharmacokinetics*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D015994:Incidence; D007297:Inpatients; D016106:Methicillin Resistance; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects*; D013647:Task Performance and Analysis; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000438:Alcohols; D000900:Anti-Bacterial Agents; D005782:Gels