June 13, 2017
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German hand hygiene campaign nearly doubles hand rub use in hospitals

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The use of alcohol-based hand rub has nearly doubled in some German hospitals thanks to a national hand hygiene campaign, study data showed.

“To reduce transmission of pathogens and thereby prevent infections, compliance with hand hygiene is considered the single most effective measure,” Wibke Wetzker, MA, of the Institut für Hygiene und Umweltmedizin at the Charité – Universitätsmedizin, Berlin, and colleagues wrote. “In January 2008, the German national hand hygiene campaign Aktion Saubere Hände (ASH) was launched as part of a strategy of multiple interventions based on the framework of the World Health Organization’s Clean Care is Safer Care program to improve hand hygiene adherence in health care settings.”

The researchers evaluated data from 132 hospitals with 1,092 units – all units that had reported hand hygiene data continuously from 2008 to 2017. Wetzker and colleagues stratified data for ICUs and non-ICUs, as well as by medical specialty, calculating annual changes in hand rub consumption by milliliters per patient day. Data on hand rub consumption were grouped into quartiles.

Overall, the researchers reported a 94% median increase in consumption of hand rub from 2007 to 2015. In non-ICU units (n = 913), the increase was 101% from baseline, compared with 75% in 179 ICUs. Units in the quartile that showed the lowest use of hand rub at baseline (Q1) demonstrated the largest overall increase, rising by 142%, whereas the second and third quartiles showed 98% and 74% increases, respectively. The fourth quartile, which had the highest use of hand rub at baseline, increased its use by 60%, Wetzker and colleagues wrote.

Quartiles 1, 2 and 3 showed a significant annual increase almost every year, except for Q3 in the first year of the intervention (2007 vs. 2008; P = .316), the researchers reported. The fourth quartile showed significant increases starting in 2012 and onward (2007 vs. 2012; P = .037). However, in non-ICUs, hand rub consumption increased significantly each year except for the first year in the fourth quartile (2007 vs. 2008; P = .159).

“The evaluation of [alcohol-based hand rub consumption] data collected through the surveillance module…established two key findings: First, [alcohol-based hand rub consumption] nearly doubled in 132 German hospitals from 2007 to 2015,” the researchers wrote. “Second, units that started with a low [alcohol-based hand rub consumption] at baseline and units who recorded a high [alcohol-based hand rub consumption] ab initio both achieved a significant increase of [alcohol-based hand rub consumption] in the long term. These results highlight the strength of a long-term surveillance program accompanying multimodal intervention (and follow-up), such as the ASH national hand-hygiene campaign.” – by Andy Polhamus

Disclosure: The researchers report no relevant financial disclosures.

Infographic shows dramatic increase in use of antibacterial hand rub in German hospitals