Additionally, the authors are grateful to Prof. Calvin Kunin and Prof. Wei-Chuan Hsieh for their suggestions and critical review of the manuscript. We chose to superimpose the hand hygiene program on a well-established infection control program using standardized surveillance methods. A fine of US$3.00 for compliance failures (individual level) was implemented in 2007 in highly specific situations, that is, individuals not modify their behavior even after face-to-face communication. The cumulative incidence of HAIs was defined as episodes per 1,000 patient-days. https://doi.org/10.1371/journal.pone.0027163.s001. Patients were followed up until hospital discharge. This study was approved by the Institutional Ethics Review Board of the National Taiwan University Hospital (No. The hand hygiene program was announced and promoted hospital-wide for one month every year while preparing for pandemic influenza (typically during November). The program was reviewed, revised, and promoted annually according to the plan-do-check-act cycle [8]. Use 1 hand to rub the back of the other hand and clean in between the fingers. Cost-benefit analyses were also conducted to examine the net benefit and benefit-cost ratio of the program. This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. No, Is the Subject Area "Nosocomial infections" applicable to this article? Is the Subject Area "Hygiene" applicable to this article? The program was associated with a reduction in the HAIs of most hospital units and HAIs caused by MRSA and XDRAB. Discover a faster, simpler path to publishing in a high-quality journal. The authors’ conclusions appear robust. Some costs were varied in the sensitivity analysis. 1A). Frequent hand-washing is standard advice for avoidance of respiratory tract infections, but the evidence for a preventive effect in a general community setting is sparse. Panel B shows significant increases in the annual consumption of alcohol-based hand rub (p = 0.001), antiseptics (p = 0.04), and liquid soap (p = 0.03). The clinical analysis was based on a comparative study with historical control carried out at a single teaching hospital. Data were collected on standardized data collection forms and inputted into the computer database manually. The cost of personnel involved in the program (including planning, training, and auditing) was not considered in the base-case analysis (Table S2), because the program did not incur any increases in staff or manpower costs. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Use Section 4 and Annex 8 to learn details about each potential indicator you are considering and how you will operationalize the indicators you have chosen. The intervention had no discernable impact on HAI rates in the hematology/oncology wards. It all depends on your environment and what are you doing throughout the day. No, Is the Subject Area "Soaps" applicable to this article? We used a quasi-experimental, before and after, study design [7] with prospective hospital-wide surveillance of HAIs to assess the effectiveness of hand hygiene. Supplementary costs associated with the increased use of alcohol-based hand rub averaged US$6.07 per 100 patient-days. Our recent survey demonstrated that the HH rate for 5 moments was only approximately 60%; whereas the HH rate for two moments exceeded 90% (unpublished data). 4. Safety glasses do not cover the whole face from chemical splashes and other hazardous materials; Psychological affect: the wearer may feel more protected than they actually are, leading to health and safety abuses There are a few disadvantages with the space saving machine though, and one of the disadvantages is that this kind of washing machine will not hold a … The baseline evaluation included direct observation of hand hygiene compliance by infection control nurses, a survey of knowledge and the reasons or factors affecting hand hygiene adherence using a structured, self-administered questionnaire, and suggestions to improve hand hygiene performance. Study groups were not well balanced at baseline due to statistically significant differences in number of patient-days, comorbidity index and frequency of underlying comorbidities. Conceived and designed the experiments: YCC WHS JTW HCL. Pittet and colleagues [24] estimated the program costs to be less than US$57,000 per year for a 2,600-bed hospital, an average of US$1.42 per admitted patient. The authors concluded that the hand hygiene programme was feasible and reduced both healthcare-associated infection rates and hospital costs. The generalized autoregressive Poisson model. Yes • Several studies have concluded that the risk of spreading gastrointestinal (stomach) and respiratory infection is decreased among families who use hand sanitizers. [2], [24]. This model autocorrelates the HAI cases in successive periods by incorporating the autoregressive order j term and number of HAI cases at an earlier time t-j [17]. Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Affiliations PLOS ONE 2011; 6(11): e27163, Anti-Infective Agents, Local /pharmacology; Bacterial Infections /prevention & Female; Guideline Adherence /statistics & Hand /microbiology; Health Personnel /statistics & Humans; Infection Control /economics /methods /statistics & Male; Middle Aged; Prospective Studies; control; numerical data; numerical data; numerical data, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0027163, Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections, Chen YC, Sheng WH, Wang JT, Chang SC, Lin HC, Tien KL, Hsu LY, Tsai KS. This represented another good feature of the study. The World Health Organization launched the World Alliance for Patient Safety in October 2004 [2]. This enabled us to determine the differences in HAI incidences over 4-year preintervention and postintervention periods, and conduct numerous observations while adjusting to changes in the frequency and severity of underlying diseases. Extensively drug-resistant A. baumannii (XDRAB) was defined as isolates that were resistant to five or more classes of antibacterial agents [6]. (2011) Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing Healthcare–Associated Infections. here. Poisson regression analyses were employed to evaluate the densities and trends of HAIs during the preintervention (January 1999 to March 2004) and intervention (April 2004 to December 2007) periods. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. For people who find that soap causes skin irritation, it is useful to note that soaps can have a different pH – they may be neutral, slightly alkaline or slightly acidic, and perfumes in soap may also cause irritation. In addition, this study showed that the cost of alcohol hand rub and the number of averted HAI episodes are the two factors influencing the additional costs of preventing one HAI episode, which subsequently influences the net benefit and benefit-cost ratio. In order to achieve greater public health benefits associated with good hand-washing practices, WASH actors need to identify and apply collaborative and The difference in patient population during the two periods was examined using Student's t-test (continuous variables) and a chi-squared test (categorical variables). Though hand sanitizer is an effective option to wash your hands, it has its own set of pros and cons. Yes The distribution and time trends of HAIs and infection control programs during 1981 to 2007 have been described previously [6]. Before intervention, HAI increased gradually, and the impact of SARS and seasons were significant. The hand hygiene compliance rates recorded for comparison between hospital services or between years were limited to the opportunities before and after patient contact to maintain consistency during the study period. Parameter estimates, standard errors and To use hand sanitizer correctly, apply the specified amount as directed by the product's label to the palm of one hand, and rub the sanitizer thoroughly over both hands until they feel dry. Affiliations Implementation of a HHP reduces preventable HAIs and is cost effective. Approximately one third of the hospital's house staff on the floor are replaced each year. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan, Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI). The spread of bacterial eye infections, such as trachoma, can be reduced through regular hand washing. Disposable alcohol-based hand rub sanitizers (75% isopropyl alcohol in plastic hand-compressing dispensers) (So Easy liquid, PBF, Taiwan) were wall mounted between every two beds in general wards, by each bed in special units (such as intensive care units), and affixed to trolleys (including treatment trolleys and resuscitation trolleys) to ensure accessibility near or at the point of care [2]. Hand-washing with water and soap, in particular, is shown to significantly reduce the microbial load of the hands [7] and was shown to reduce the risk of diarrhea with 39-47% [6] [7] [8][9][10]. A disease-specific measure was used to examine the clinical impact of the programme on patients’ health. The study was based on sophisticated methodology that was used to overcome some issues related to the clinical design of the study. HAIs have been identified as a fundamental priority, and were selected as the topic of the first Global Patient Safety Challenge. Endogenous infection may be reduced through improvements in host immunity. The comparator was the standard pattern of care before implementation of the programme: hands-free washing facilities with non-medicated liquid soap (not refilled) and paper towels located in every room of the wards and by every intensive care unit bed. e27163. The net benefit of the HHP was US$5,289,364, and the benefit-cost ratio was 23.7 with a 3% discount rate. The extra cost of the programme to prevent one episode of healthcare-associated infection was $163.6. The study examined the cost-effectiveness of a hand hygiene programme to reduce the burden of healthcare-associated infections. improved hand hygiene practices lead to a reduction of HAIs and/or transmission or colonization by MDROs. We are grateful to members of the NTUH Center for Infection Control and Center for Quality Control for their support of the hand hygiene program and the hospital staff for their commitment to improve patient safety and reduce healthcare-associated infections. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label. Our data failed to support the effects of HHP on decreasing HAIs among hemato-oncology patients and patients with infections caused by MSSA and E. coli. Are relevant to this article Chen Y-C, Sheng W-H, Wang JT, Chang SC, HC. Were intensified during June 2001 to June 2002 November ) to this article RLU level is... 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