Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: An interrupted time series over a 10-year period

• Published in: American journal of infection control Vol. 42; no. 7; pp. 718 - 722
• Main Authors: Helder, Onno K., RN, PhD, Brug, Johannes, PhD, van Goudoever, Johannes B., MD, PhD, Looman, Caspar W.N., MSc, Reiss, Irwin K.M., MD, PhD, Kornelisse, René F., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2014; Elsevier; Mosby-Year Book, Inc
• Subjects: Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Blood diseases; Compliance; Cross Infection - epidemiology; Cross Infection - prevention & control; Epidemiology. Vaccinations; General aspects; Hand disinfection; Hand Hygiene - methods; Health promotion; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Hygiene; Incidence; Infant; Infant, Newborn; Infant, Very Low Birth Weight; Infection Control; Infectious Disease; Infectious diseases; Interrupted time series; Interrupted Time Series Analysis; Intervention; Medical sciences; Nosocomial infections; Nursing intervention; Prospective Studies; Retrospective Studies; Sepsis - epidemiology; Sepsis - prevention & control; Staphylococcus aureus - isolation & purification; Time series; Hand disinfection; Infant; Nursing intervention; Interrupted time series; Infection control; Human; Premature; Nosocomial infection; Pregnancy disorders; Health care staff; Check; Disinfection; Hand; Bacteremia; Infection; Prevention; Very low birthweight; Newborn diseases; Prematurity; Bacteriosis; Hygiene; Nurse
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2014.04.005

Background Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. Methods An observational study with an interrupted time series analysis of the occurrence of NBSI was performed in very low-birth weight (VLBW) infants. Interventions consisted of an education program, gain-framed screen saver messages, and an infection prevention week with an introduction on consistent glove use. Results A total of 1,964 VLBW infants admitted between January 1, 2002, and December 31, 2011, were studied. The proportion of infants with ≥1 NBSI decreased from 47.6%-21.2% ( P  < .01); the number of NBSIs per 1,000 patient days decreased from 16.8-8.9 ( P  < .01). Preintervention, the number of NBSIs per 1,000 patient days significantly increased by 0.74 per quartile (95% confidence interval [CI], 0.27-1.22). The first intervention was followed by a significantly declining trend in NBSIs of -1.27 per quartile (95% CI, -2.04 to -0.49). The next interventions were followed by a neutral trend change. The relative contributions of coagulase-negative staphylococci and Staphylococcus aureus as causative pathogens decreased significantly over time. Conclusions Sequential HH promotion seems to contribute to a sustained low NBSI rate.