title: Features of educational interventions that lead to compliance with hand hygiene in healthcare professionals within a hospital care setting. A BEME systematic review: BEME Guide No. 22.
abstract: BACKGROUND
  In the United Kingdom, there are approximately 300,000 healthcare-associated infections (HCAI) annually, costing an estimated £1 billion. Up to 30% of all HCAI are potentially preventable by better application of knowledge and adherence to infection prevention procedures. Implementation of Department of Health guidelines through educational interventions has resulted in significant and sustained improvements in hand hygiene compliance and reductions in HCAI.
  
  
  OBJECTIVE
  To determine the features of structured educational interventions that impact on compliance with hand hygiene in healthcare professionals within a hospital care setting.
  
  
  METHODS
  Sixteen electronic databases were searched. Outcomes were assessed using Kirkpatrick's hierarchy and included changes in hand hygiene compliance of healthcare professionals, in service delivery and in the clinical welfare of patients involved.
  
  
  RESULTS
  A total of 8845 articles were reviewed, of which 30 articles met the inclusion criteria. Delivery of education was separated into six groups.
  
  
  CONCLUSIONS
  It was not possible to identify individual features of educational interventions due to each study reporting multicomponent interventions. However, multiple, continuous interventions were better than single interventions in terms of eliciting and sustaining behaviour change. Data were not available to determine the time, nature and type of booster sessions with feedback needed for a permanent change in compliance.
authors.affiliation: Centre for Excellence in Evidence Based Teaching and Learning (CEEBLT), UK. m.g.cherry@liverpool.ac.uk
authors.forename: Mary Gemma
authors.initials: MG
authors.lastname: Cherry
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Brown
authors.forename: George S
authors.initials: GS
authors.lastname: Bethell
authors.forename: Tim
authors.initials: T
authors.lastname: Neal
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Shaw
mesh_terms: D003428:Cross Infection / Q000517:prevention & control; D019983:Guideline Adherence; D006235:Hand Disinfection; D006282:Health Personnel / Q000193:education*; D006739:Hospital Administration; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007318:Inservice Training / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D006113:United Kingdom