title: E-learning may improve adherence to alcohol-based hand rubbing: a cohort study.
abstract: BACKGROUND
  Since 2004, we have promoted alcohol-based hand rubbing (HR) with an e-learning program (ELP) among hospital staff. This study sought to determine whether an ELP improves adherence to correct HR.
  
  
  METHODS
  This was a cohort study of staff members at Aarhus University Hospital, Skejby, Denmark who completed the ELP and were repeatedly observed for correct HR before and after clinical procedures in 2006 and/or 2007.
  
  
  RESULTS
  Of the 496 participants, 13% completed the ELP in both 2006 and 2007, 29% completed the ELP only in 2006, 15% completed the ELP only in 2007, and 43% never completed the ELP. Compared with noncompleters, completers of the 2006 and 2007 ELP had a significantly higher adherence to correct HR both before clinical procedures (odds ratio [OR] = 1.54; 95% confidence interval [CI] = 1.11 to 2.13) and after clinical procedures (OR = 1.40; 95% CI = 1.03 to 1.89). Time since completing the ELP seemed to be inversely associated with adherence to correct HR.
  
  
  CONCLUSIONS
  Completion of an ELP may have a positive impact on the performance of correct HR. The demands of lifelong education and training of hospital staff may call for the use of an ELP as a supplement to existing efforts aimed at improving HR to help prevent health care-related infections.
authors.affiliation: Department of Clinical Microbiology, Aarhus University Hospital, Skejby, DK-8200 Aarhus N, Denmark. sussie.laustsen@ki.au.dk
authors.forename: Sussie
authors.initials: S
authors.lastname: Laustsen
authors.forename: Bo Martin
authors.initials: BM
authors.lastname: Bibby
authors.forename: Brian
authors.initials: B
authors.lastname: Kristensen
authors.forename: Jens Kjølseth
authors.initials: JK
authors.lastname: Møller
authors.forename: Ane Marie
authors.initials: AM
authors.lastname: Thulstrup
mesh_terms: D000985:Antisepsis / Q000379:methods* / Q000592:standards; D015331:Cohort Studies; D003428:Cross Infection / Q000517:prevention & control*; D003718:Denmark; D020375:Education, Distance / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D020407:Internet; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010564:Personnel, Hospital / Q000193:education*; D012915:Soaps / Q000008:administration & dosage
chemical_list: D012915:Soaps; D000431:Ethanol