title: The short-term and long-term effectiveness of a multidisciplinary hand hygiene improvement program.
abstract: BACKGROUND
  Although hand hygiene (HH) compliance has been an important issue for years, the compliance rate is still a problem in health care today.
  
  
  METHODS
  This was an observational, prospective, before-and-after study. We measured HH knowledge and HH compliance before (baseline), directly after (poststrategy), and 6 months after the performance of HH team strategies (follow-up). The study was composed of employed nurses and physicians working in the department of internal medicine of a university hospital. We performed a multifaceted improvement program including HH education, feedback, reminders, social influence activities including the use of role models, and improvement of HH facilities.
  
  
  RESULTS
  Ninety-two nurses and physicians were included. Compared with baseline, there was a significant improvement in the overall mean HH knowledge score at poststrategy (from 7.4 to 8.4) and follow-up (from 7.4 to 8.3). The overall HH compliance was 27% at baseline, 83% at poststrategy, and 75% at follow-up. At baseline, the compliance rate was 17% in nurses and 43% in physicians and significantly improved to 63% in nurses and 91% in physicians at follow-up.
  
  
  CONCLUSIONS
  Our multifaceted HH improvement program resulted in a sustained improvement of HH knowledge and compliance in nurses as well as physicians.
authors.affiliation: Nijmegen Institute for Infection, Inflammation, and Immunity (N4i), Radboud University Nijmegen Medical Centre, The Netherlands. m.tromp@aig.umcn.nl
authors.forename: Mirjam
authors.initials: M
authors.lastname: Tromp
authors.forename: Anita
authors.initials: A
authors.lastname: Huis
authors.forename: Inge
authors.initials: I
authors.lastname: de Guchteneire
authors.forename: Jos
authors.initials: J
authors.lastname: van der Meer
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
authors.forename: Marlies
authors.initials: M
authors.lastname: Hulscher
authors.forename: Chantal
authors.initials: C
authors.lastname: Bleeker-Rovers
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000379:methods / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017757:Infectious Disease Transmission, Professional-to-Patient; D009426:Netherlands / Q000453:epidemiology; D009726:Nurses; D010820:Physicians; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies