Action research on promoting hand hygiene practices in an intensive care unit.
Kirsi Terho, Esa Rintala, Janne Engblom and 1 others
PMID 36594651WHAT IT FOUND
ICU infection rates and alcohol-based hand-rub use did not change reliably over four years, but hand hygiene compliance rose from 59.6% to 68.3% after link-nurse observations.
Key findings
01The overall ICU infection-rate trend from 2015 to 2017 was not statistically significant.
02Hand hygiene compliance increased from 59.6% in the first observation cycle to 68.3% in the second observation cycle.
03Alcohol-based hand-rub use increased by 6.7 L per 1000 patient days per year, but this was not statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No power analysis was performed before the study. The study was conducted in one ICU without a control unit, so other changes could explain trends. Physicians' hand-hygiene compliance was not observed, so overall compliance may be overestimated. Observations were not made across all 24 hours, and different observers conducted the two cycles. Alcohol-based hand-rub consumption could include use by non-staff and did not show whether hand hygiene happened at the right moment.
Declared interests
Supported by the Päivikki and Sakari Sohlberg Foundation, the National League for Nursing's Foundation for Nursing Education, the Finnish Nurses Association, the Rauno and Anne Puolimatka Foundation, the Finnish Cultural Foundation, and state research grants; the funders had no role in conduct or reporting.
The easy way to misread this
Do not conclude that the hand-hygiene programme reduced ICU infections. The overall infection-rate trend was not statistically significant, and the study could not separate hand hygiene from other unit changes.