Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit.
OBJECTIVE
To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).


METHODS
Open trial.


METHODS
A level-III NICU in a teaching hospital.


METHODS
Nurses, physicians, and other healthcare workers in the NICU.


METHODS
A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.


RESULTS
Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P = .003) with improved handwashing compliance. In particular, respiratory tract infections decreased from 3.35 to 1.06 per 1,000 patient-days during the handwashing campaign (P = .002). Furthermore, the correlation between nosocomial infection of the respiratory tract and handwashing compliance also reached statistical significance (r = -0.385; P = .014).


CONCLUSIONS
Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU.
Won
Sau-Pin
SP
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
Chou
Hung-Chieh
HC
Hsieh
Wu-Shiun
WS
Chen
Chien-Yi
CY
Huang
Shio-Min
SM
Tsou
Kuo-Inn
KI
Tsao
Po-Nien
PN
D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D019983:Guideline Adherence; D006235:Hand Disinfection; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007231:Infant, Newborn; D007318:Inservice Training; D007363:Intensive Care Units, Neonatal; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology