title: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in three cities of Colombia.
abstract: OBJECTIVE
  To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene (HH) approach in Colombia, and analyze predictors of poor HH compliance.
  
  
  METHODS
  An observational, prospective, interventional, before-and-after study was conducted from May 2003 through September 2010 in 10 intensive care units (ICUs) of six hospitals in three cities. The study was divided into two periods: a baseline and a follow-up period. Observations for HH compliance were done in each ICU during randomly selected 30-min periods. The multidimensional HH approach included: (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback.
  
  
  RESULTS
  A total of 13 187 opportunities for HH were observed. Overall HH compliance increased from 50% to 77% (relative risk 1.55, 95% confidence interval 1.43-1.68; p=0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor HH compliance: males vs. females (67% vs. 77%; p=0.0001), physicians vs. nurses (59% vs. 78%; p<0.0001), and adult vs. pediatric ICUs (76% vs. 42%; p<0.001), among others.
  
  
  CONCLUSIONS
  Adherence to HH was increased by 55% with the INICC approach. Programs targeted at improving HH in variables found to be predictors of poor compliance should be implemented.
authors: Universidad Simón Bolívar, Barranquilla, Colombia.
authors: Nayide
authors: N
authors: Barahona-Guzmán
authors: Hospital La Victoria, Bogotá, Colombia.
authors: María Eugenia
authors: ME
authors: Rodríguez-Calderón
authors: International Nosocomial Infection Control Consortium (INICC), Corrientes Ave 4580, Floor 12, Apt D, Buenos Aires, ZIP 1195, Argentina. Electronic address: victor_rosenthal@inicc.org.
authors: Victor D
authors: VD
authors: Rosenthal
authors: Hospital El Tunal ESE, Bogotá, Colombia.
authors: Narda
authors: N
authors: Olarte
authors: Clínica Santa María, Sucre, Colombia; Clínica de la Sabana, Sucre, Colombia.
authors: Wilmer
authors: W
authors: Villamil-Gómez
authors: Centro Policlínico del Olaya, Bogotá, Colombia.
authors: Catherine
authors: C
authors: Rojas
authors: Universidad Simón Bolívar, Barranquilla, Colombia.
authors: Marena
authors: M
authors: Rodríguez-Ferrer
authors: Universidad Simón Bolívar, Barranquilla, Colombia.
authors: Guillermo
authors: G
authors: Sarmiento-Villa
authors: Universidad Simón Bolívar, Barranquilla, Colombia.
authors: Alfredo
authors: A
authors: Lagares-Guzmán
authors: Hospital El Tunal ESE, Bogotá, Colombia.
authors: Alberto
authors: A
authors: Valderrama
authors: Clínica Santa María, Sucre, Colombia.
authors: Antonio
authors: A
authors: Menco
authors: Clínica Santa María, Sucre, Colombia; Clínica de la Sabana, Sucre, Colombia.
authors: Patrick
authors: P
authors: Arrieta
authors: Clínica de la Sabana, Sucre, Colombia.
authors: Luis Enrique
authors: LE
authors: Dajud-Cassas
authors: Clínica de la Sabana, Sucre, Colombia.
authors: Mariela
authors: M
authors: Mendoza
authors: Centro Policlínico del Olaya, Bogotá, Colombia.
authors: Alejandra
authors: A
authors: Sabogal
authors: Centro Policlínico del Olaya, Bogotá, Colombia.
authors: Yulieth
authors: Y
authors: Carvajal
authors: Centro Policlínico del Olaya, Bogotá, Colombia.
authors: Edwin
authors: E
authors: Silva
mesh_terms: D002947:Cities; D015331:Cohort Studies; D003105:Colombia; D003428:Cross Infection / Q000517:prevention & control*; D003906:Developing Countries; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D063373:Hand Hygiene / Q000379:methods / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010564:Personnel, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011446:Prospective Studies
keywords: Bundle; Developing countries; Hand hygiene; Intensive care unit; International Nosocomial Infection Control Consortium; Multidimensional approach