title: Making infection prevention education interactive can enhance knowledge and improve outcomes: Results from the Targeted Infection Prevention (TIP) Study.
abstract: The purpose of this study was to assess effectiveness of an interactive educational program in increasing knowledge of key infection prevention and control (IPC) principles with emphasis on indwelling device care, hand hygiene, and multidrug-resistant organisms (MDROs) among nursing home (NH) health care personnel (HCP).
  
  
  
  We conducted a multimodal randomized controlled study involving HCP at 12 NHs. Ten comprehensive and interactive modules covered common IPC topics. We compared intervention and control scores to assess differences in pretest scores as a result of field interventions, pre- and post-test scores to assess knowledge gain, and magnitude of knowledge gain based on job categories.
  
  
  
  We conducted over 200 in-services across 10 topics at six intervention sites over 36 months. There were 4,962 tests returned over the course of the study, ranging from 389-633 per module. Participants were mostly female certified nursing assistants (CNAs). Score improvement was highest for modules emphasizing hand hygiene, urinary catheter care, and MDROs (15.6%, 15.9%, and 22.0%, respectively). After adjusting for cluster study design, knowledge scores were significantly higher after each educational module, suggesting the education delivery method was effective. When compared with CNAs, nursing and rehabilitation personnel scored significantly higher in their knowledge tests.
  
  
  
  Our intervention significantly improved IPC knowledge in HCP, especially for those involved in direct patient care. This increase in knowledge along with preemptive barrier precautions and active surveillance has enhanced resident safety by reducing MDROs and infections in high-risk NH residents.
authors.affiliation: Divisions of Geriatric and Palliative Care Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Evonne
authors.initials: E
authors.lastname: Koo
authors.affiliation: Divisions of Geriatric and Palliative Care Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Sara
authors.initials: S
authors.lastname: McNamara
authors.affiliation: Divisions of Geriatric and Palliative Care Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Lansing
authors.affiliation: Infection Prevention and Control, Trinity Health, Livonia, MI.
authors.forename: Russell N
authors.initials: RN
authors.lastname: Olmsted
authors.affiliation: Long-term Care Infection Prevention & Control Consultant, Hemlock, MI.
authors.forename: Ruth Anne
authors.initials: RA
authors.lastname: Rye
authors.affiliation: Divisions of Geriatric and Palliative Care Medicine, University of Michigan, Ann Arbor, MI; Geriatric Research Education and Clinical Center, Veteran's Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fitzgerald
authors.affiliation: Divisions of Geriatric and Palliative Care Medicine, University of Michigan, Ann Arbor, MI; Geriatric Research Education and Clinical Center, Veteran's Affairs Ann Arbor Healthcare System, Ann Arbor, MI. Electronic address: lonamody@umich.edu.
authors.forename: Lona
authors.initials: L
authors.lastname: Mody
mesh_terms: D065187:Controlled Before-After Studies; D003428:Cross Infection / Q000517:prevention & control*; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D009735:Nursing Homes; D011361:Professional Competence; D011897:Random Allocation
keywords: Educational intervention; health care personnel; infection control and prevention; knowledge improvement; nursing homes