title: Changes in healthcare-associated Staphylococcus aureus bloodstream infections after the introduction of a national hand hygiene initiative.
abstract: BACKGROUND
  Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection.
  
  
  METHODS
  We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated Staphylococcus aureus bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time.
  
  
  RESULTS
  The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates.
  
  
  CONCLUSIONS
  The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative's introduction or because infection rates were already low and could not be further reduced.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.forename: Katie
authors.initials: K
authors.lastname: Page
authors.forename: Megan
authors.initials: M
authors.lastname: Campbell
authors.forename: David
authors.initials: D
authors.lastname: Brain
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Martin
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rashleigh-Rolls
authors.forename: Kate
authors.initials: K
authors.lastname: Halton
authors.forename: Lisa
authors.initials: L
authors.lastname: Hall
authors.forename: Nerina
authors.initials: N
authors.lastname: Jimmieson
authors.forename: Katherine
authors.initials: K
authors.lastname: White
authors.forename: David
authors.initials: D
authors.lastname: Paterson
authors.forename: Nicholas
authors.initials: N
authors.lastname: Graves
mesh_terms: D001315:Australia / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods / Q000592:standards; D006293:Health Promotion; D006801:Humans; D010564:Personnel, Hospital / Q000193:education / Q000706:statistics & numerical data; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control