4. Gould et al. (2017). A systematic review to assess success of hand hygiene improvement strategies and to determine if increased compliance reduces the rates of HAIs. Evidence level is 1. 52 studies were included with varied designs, setting and sample size. Participants were random. All studies agree that either single or multi-modal strategies led to increased compliance. It is unclear which combination of strategies are most effective however, HAI rates were reduced. 5. Kingston, et al. (2015). This is a systematic review with an evidence level of 1. The aim is to report the outcomes of published peer-reviewed studies on hand hygiene compliance among healthcare workers. 16 articles were included with varied designs, settings and sample size. All studies agree that multi-modal strategies for hand hygiene improvement show slight to moderate improvement in compliance. 6. Luangasanatip, et al. (2015). A systematic review to evaluate effectiveness of interventions promoting hand hygiene in the hospitals. 82 articles were included that have evaluated at least one intervention to improve hand hygiene compliance, measurable results with pre- specified indications. Design, setting and sample size varied. Interventions included direct observation or electronic counters. All agree that a multi-modal approach shows improvement in compliance.
14 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL 7. Neo et al. (2016). An integrated review to provide a comprehensive summary of recently published evidence-based interventions to improve hand hygiene compliance. Evidence level is 5. 73 articles were included. Design, settings and interventions varied. All agree that future research is needed to replicate successful hygiene in other healthcare environments. 8. Villa et al. (2015). This is a stepped-wedge RCT with an evidence level of II. 705 studies were included. Design, setting and interventions varied. Purpose is to estimate effects of multi-modal interventions to improve hand hygiene compliance in ICU heath workers. Included criteria are ICU programs with a design to prevent HAIs and have at least one infection control practitioner over HAI program. Interventions are measurable for compliance improvement. All agree that multi-modal interventions were effective in improving hand hygiene in ICUs with moderate compliance. 9. Stewardson et al. (2016). This is an RCT with an evidence level of II. Purpose: to assess the effects of feedback and patient participation on hand hygiene compliance. 67 studies were included. Design, settings and interventions varied. Results were measurable and improved in both the control group and enhanced performance feedback group. All agree that combination interventions improve compliance . Strengths and Weaknesses There are a few strengths and weakness that the reviewed literature had in common.
- Winter '16
- The Land, HAIs, BEMC