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Interventions to improve healthcare workers’ hand hygiene compliance: A systematic review of systematic reviews

Published online by Cambridge University Press:  11 December 2018

Lesley Price Open the ORCID record for Lesley Price [Opens in a new window] ,
Jennifer MacDonald ,
Lucyna Gozdzielewska ,
Tracey Howe ,
Paul Flowers ,
Lesley Shepherd ,
Yvonne Watt  and
Jacqui Reilly
Lesley Price*
Affiliation:
Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Jennifer MacDonald
Affiliation:
Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Lucyna Gozdzielewska
Affiliation:
Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Tracey Howe
Affiliation:
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Paul Flowers
Affiliation:
Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Lesley Shepherd
Affiliation:
Health Protection Scotland, Glasgow, Scotland, United Kingdom
Yvonne Watt
Affiliation:
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
Jacqui Reilly
Affiliation:
Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom Health Protection Scotland, Glasgow, Scotland, United Kingdom
*
Author for correspondence: Lesley Price, Safeguarding Health through Infection Prevention Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK. E-mail: L.Price@gcu.ac.uk
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Abstract

Objective

To synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).

Methods

PRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.

Results

Overall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.

Conclusions

This is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 12 , December 2018 , pp. 1449 - 1456
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

PREVIOUS PRESENTATION: Results based on a search of the literature up to June 2016 were presented on September 19, 2017, at the Annual Conference of the Infection Prevention Society, held in the Manchester Central Convention Complex, England, United Kingdom. This presentation resulted in the following abstract: Price L, MacDonald J, Gozdzielewska L, et al. An overview of systematic reviews of interventions designed to improve healthcare workers’ hand hygiene compliance. J Infect Prev 2017;18:S56–S57.

Cite this article: Price L, et al. (2018). Interventions to improve healthcare workers’ hand hygiene compliance: A systematic review of systematic reviews. Infection Control & Hospital Epidemiology 2018, 39, 1449–1456. doi: 10.1017/ice.2018.262

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