title: Student-led intervention to inNOvate hand hygiene practice in Auckland Region's medical students (the No HHARMS study).
abstract: BACKGROUND
  Hand hygiene is important in reducing healthcare-associated infections. The World Health Organization has defined 'five moments' when hand hygiene compliance is required. During 2013, New Zealand national data showed poor compliance with these moments by medical students.
  
  
  OBJECTIVE
  To improve medical students' compliance with the five moments.
  
  
  METHODS
  In this prospective student-led quality improvement initiative, student investigators developed, implemented and evaluated a multi-modal intervention comprising a three-month social media campaign, a competition and an entertaining educational video. Data on individual patient-medical student interactions were collected covertly by observers at baseline and at one week, six weeks and three months after initiation of the intervention.
  
  
  RESULTS
  During the campaign, compliance improved in moment 2, but not significantly in moments 1, 3, 4 or 5. Statistical analysis of amalgamated data was limited by non-independent data points-a consideration apparently not always addressed in previous studies.
  
  
  CONCLUSIONS
  The initiative produced improvements in compliance by medical students with one hand hygiene moment. Statistical analysis of amalgamated data for all five moments should allow for the non-independence of each occasion in which clinicians interact with a patient. More work is needed to ensure excellent hand hygiene practices of future doctors.
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: Nathanael Cc
authors.initials: NC
authors.lastname: Lucas
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: Carl G
authors.initials: CG
authors.lastname: Hume
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: Abdal
authors.initials: A
authors.lastname: Al-Chanati
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: William
authors.initials: W
authors.lastname: Diprose
authors.affiliation: Microbiology Department, LabPlus, Auckland District Health Board, Auckland.
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
authors.affiliation: Microbiology Department, LabPlus, Auckland District Health Board, Auckland.
authors.forename: Josh
authors.initials: J
authors.lastname: Freeman
authors.affiliation: Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: Vernon
authors.initials: V
authors.lastname: Mogol
authors.affiliation: School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland.
authors.forename: David
authors.initials: D
authors.lastname: Hoskins
authors.affiliation: Health Quality & Safety Commission, Wellington.
authors.forename: Richard
authors.initials: R
authors.lastname: Hamblin
authors.affiliation: Department of Medicine, Christchurch School of Medicine and Health Sciences, The University of Otago, Christchurch.
authors.forename: Chris
authors.initials: C
authors.lastname: Frampton
authors.affiliation: Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Auckland City Hospital, Grafton, Auckland.
authors.forename: Warwick
authors.initials: W
authors.lastname: Bagg
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Auckland City Hospital, Grafton, Auckland.
authors.forename: Alan F
authors.initials: AF
authors.lastname: Merry
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000592:standards*; D009520:New Zealand; D011446:Prospective Studies; D013337:Students, Medical; D014944:World Health Organization