title: Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach During 3 Years in 6 Hospitals in 3 Mexican Cities.
abstract: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene (HH) approach in Mexico, and analyze predictors of poor HH compliance.
  
  
  
  From June 2002 to April 2006, we conducted a prospective, observational, before-and-after study in 8 intensive care units (ICUs) from 6 hospitals in 3 cities of Mexico. The approach included administrative support, availability of supplies, education and training, reminders in the workplace, process surveillance, and performance feedback.
  
  
  
  A total of 13,201 observations for HH opportunities were done in each ICU, during randomly selected 30-minute periods. Overall, HH compliance increased from 45% to 79% (95% confidence interval [CI], 69.1-86.5; P = 0.01). Univariate and multivariate analyses showed that several variables were significantly associated with poor HH compliance: males versus females (61% versus 66%; 95% CI, 0.91-0.96; P = 0.0001), physicians versus nurses (62% versus 67%; 95% CI, 0.91-0.97; P = 0.0001), and adult versus neonatal ICUs (67% versus 54%; 95% CI, 0.79-0.84; P = 0.0001), among others.
  
  
  
  Hand hygiene programs should focus on variables found to be predictors of poor HH compliance.
authors.forename: María Guadalupe
authors.initials: MG
authors.lastname: Miranda-Novales
authors.affiliation: Hospital de la Mujer, Mexico City, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Sobreyra-Oropeza
authors.affiliation: International Nosocomial Infection Control Consortium (INICC), Buenos Aires, Argentina.
authors.forename: Víctor Daniel
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: Hospital General de México, Mexico City, Mexico.
authors.forename: Francisco
authors.initials: F
authors.lastname: Higuera
authors.affiliation: Centro Médico La Raza IMSS, Mexico City, Mexico.
authors.forename: Alberto
authors.initials: A
authors.lastname: Armas-Ruiz
authors.affiliation: Hospital General de la Celaya, Celaya, Mexico.
authors.forename: Irma
authors.initials: I
authors.lastname: Pérez-Serrato
authors.affiliation: Hospital General de Irapuato, Irapuato, Mexico.
authors.forename: Héctor
authors.initials: H
authors.lastname: Torres-Hernández
authors.forename: Irma
authors.initials: I
authors.lastname: Zamudio-Lugo
authors.forename: Eric M
authors.initials: EM
authors.lastname: Flores-Ruiz
authors.affiliation: Centro Médico La Raza IMSS, Mexico City, Mexico.
authors.forename: Roberto
authors.initials: R
authors.lastname: Campuzano
authors.affiliation: Centro Médico La Raza IMSS, Mexico City, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Mena-Brito
authors.affiliation: Hospital General de la Celaya, Celaya, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Sánchez-López
authors.affiliation: Hospital General de Irapuato, Irapuato, Mexico.
authors.forename: Amalia
authors.initials: A
authors.lastname: Chávez-Gómez
authors.affiliation: Hospital General de Irapuato, Irapuato, Mexico.
authors.forename: Jaime
authors.initials: J
authors.lastname: Rivera-Morales
authors.affiliation: Hospital General de Irapuato, Irapuato, Mexico.
authors.forename: Julián E
authors.initials: JE
authors.lastname: Valero-Rodríguez
mesh_terms: D000328:Adult; D002947:Cities; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D063373:Hand Hygiene / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008800:Mexico; D011446:Prospective Studies