title: Role of quality control circle in sustained improvement of hand hygiene compliance: an observational study in a stomatology hospital in Shandong, China.
abstract: BACKGROUND
  Hand hygiene is an important element of the WHO multimodal strategy for healthcare-associated infection control, whereas compliance of hand hygiene among healthcare workers (HCWs) remains a challenge to sustain. In order to increase the hand hygiene compliance of HCWs, a quality control circle (QCC) program was carried out in our hospital, and the plan-do-check-act (PDCA) method was applied for 12 months.
  
  
  RESULTS
  Hand hygiene compliance rates improved over time, with significant improvement between preintervention (60.1%) and postintervention (97.2%) periods (P< 0.001). Nurses (88.3%) exhibited higher compliance than dentists (87.3%), and female (88.4%) HCWs were more likely to perform hand hygiene than males (85.6%), bothP< 0.001. Overall hand hygiene compliance and observance of the five indications exhibited significant linear increases over time (P< 0.005).
  
  
  CONCLUSIONS
  This study highlights the success of a multifaceted intervention, conducted by QCC program and PDCA method, which led to a significant improvement of hand hygiene compliance. Though training is the most basic intervention element, surveillance, evaluation and feedback should be explored as additional interventions to ensure that hand hygiene compliance is achieved and sustained at high levels.
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong People's Republic of China.|Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong People's Republic of China.|School of Stomatology, Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of General Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yuan
authors.affiliation: Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong People's Republic of China.|School of Stomatology, Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Qinfeng
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong People's Republic of China.|School of Stomatology, Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Lili
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong People's Republic of China.|School of Stomatology, Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Hongmin
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong People's Republic of China.|School of Stomatology, Shandong University, Jinan, Shandong People's Republic of China.
authors.forename: Zhenkun
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan, Shandong People's Republic of China.|Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan, 250014 Shandong People's Republic of China.
authors.forename: Zexin
authors.initials: Z
authors.lastname: Tao
authors.affiliation: Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan, Shandong People's Republic of China.|Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan, 250014 Shandong People's Republic of China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong People's Republic of China.|Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan, Shandong People's Republic of China.|Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan, 250014 Shandong People's Republic of China.
authors.forename: Aiqiang
authors.initials: A
authors.lastname: Xu
keywords: Hand hygiene; Healthcare workers; Healthcare-associated infection; Quality control circle