title: Computer screen saver hand hygiene information curbs a negative trend in hand hygiene behavior.
abstract: BACKGROUND
  Appropriate hand hygiene among health care workers is the most important infection prevention measure; however, compliance is generally low. Gain-framed messages (ie, messages that emphasize the benefits of hand hygiene rather than the risks of noncompliance) may be most effective, but have not been tested.
  
  
  METHODS
  The study was conducted in a 27-bed neonatal intensive care unit. We performed an interrupted time series analysis of objectively measured hand disinfection events. We used electronic devices in hand alcohol dispensers, which continuously documented the frequency of hand disinfection events. In addition, hand hygiene compliance before and after the intervention period were directly observed.
  
  
  RESULTS
  The negative trend in hand hygiene events per patient-day before the intervention (decrease by 2.3 [standard error, 0.5] per week) changed to a significant positive trend (increase of 1.5 [0.5] per week) after the intervention (P < .001). The direct observations confirmed these results, showing a significant improvement in hand hygiene compliance from 193 of 303 (63.6%) observed hand hygiene events at pretest to 201 of 281 (71.5%) at posttest.
  
  
  CONCLUSIONS
  We conclude that gain-framed messages concerning hand hygiene presented on screen savers may improve hand hygiene compliance.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands. o.helder@erasmusmc.nl
authors.forename: Onno K
authors.initials: OK
authors.lastname: Helder
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Weggelaar
authors.forename: Daniël C J
authors.initials: DC
authors.lastname: Waarsenburg
authors.forename: Caspar W N
authors.initials: CW
authors.lastname: Looman
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: René F
authors.initials: RF
authors.lastname: Kornelisse
mesh_terms: D001291:Attitude of Health Personnel; D001521:Behavior Therapy; D063373:Hand Hygiene / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D007363:Intensive Care Units, Neonatal