title: Hand hygiene-related clinical trials reported since 2010: a systematic review.
abstract: Considerable emphasis is currently placed on reducing healthcare-associated infection through improving hand hygiene compliance among healthcare professionals. There is also increasing discussion in the lay media of perceived poor hand hygiene compliance among healthcare staff. Our aim was to report the outcomes of a systematic search for peer-reviewed, published studies - especially clinical trials - that focused on hand hygiene compliance among healthcare professionals. Literature published between December 2009, after publication of the World Health Organization (WHO) hand hygiene guidelines, and February 2014, which was indexed in PubMed and CINAHL on the topic of hand hygiene compliance, was searched. Following examination of relevance and methodology of the 57 publications initially retrieved, 16 clinical trials were finally included in the review. The majority of studies were conducted in the USA and Europe. The intensive care unit emerged as the predominant focus of studies followed by facilities for care of the elderly. The category of healthcare worker most often the focus of the research was the nurse, followed by the healthcare assistant and the doctor. The unit of analysis reported for hand hygiene compliance was 'hand hygiene opportunity'; four studies adopted the 'my five moments for hand hygiene' framework, as set out in the WHO guidelines, whereas other papers focused on unique multimodal strategies of varying design. We concluded that adopting a multimodal approach to hand hygiene improvement intervention strategies, whether guided by the WHO framework or by another tested multimodal framework, results in moderate improvements in hand hygiene compliance.
authors: Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland. Electronic address: liz.kingston@ul.ie.
authors: L
authors: L
authors: Kingston
authors: Department of Clinical Microbiology, University Hospital Limerick, Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland.
authors: N H
authors: NH
authors: O'Connell
authors: Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland.
authors: C P
authors: CP
authors: Dunne
mesh_terms: D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000517:prevention & control*; D005060:Europe; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D014481:United States
keywords: Compliance; Hand hygiene; Hand hygiene opportunity; Multimodal approach