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Helping hands: a cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses

Helping hands: a cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses
Helping hands: a cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses
Background: hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses.

Methods/design: this study is a cluster randomised controlled trial with inpatient wards as the unit of randomisation. Guidelines for hand hygiene will be implemented in this study. Two strategies will be used to improve the adherence to guidelines for hand hygiene. The state-of-the-art strategy is derived from the literature and includes education, reminders, feedback, and targeting adequate products and facilities. The extended strategy also contains activities aimed at influencing social influence in groups and enhancing leadership. The unique contribution of the extended strategy is built upon relevant behavioural science theories. The extended strategy includes all elements of the state-of-the-art strategy supplemented with gaining active commitment and initiative of ward management, modelling by informal leaders at the ward, and setting norms and targets within the team. Data will be collected at four points in time, with six-month intervals. An average of 3,000 opportunities for hand hygiene in approximately 900 nurses will be observed at each time point.

Discussion: performing and evaluating an implementation strategy that also targets the social context of teams may considerably add to the general body of knowledge in this field. Results from our study will allow us to draw conclusions on the effects of different strategies for the implementation of hand hygiene guidelines, and based on these results we will be able to define a preferred implementation strategy for hospital based nursing.

Trial registration: the study is registered as a Clinical Trial in ClinicalTrials.gov, dossier number: NCT00548015
101-107
Huis, Anita
cceacfe4-1e7c-46ce-94d4-ca778ad9f644
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Grol, Richard
7079ec99-ac2b-4d24-9ddd-513e32814c04
Borm, George
f30d90af-d561-4be6-a156-0903d166a4d1
Adang, Eddy
635fd5d4-2df6-4306-b6b3-9e736ef40253
Hulscher, Marlies
cbd15b6a-6e4d-4831-9c8a-3df23fd53fba
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30
Huis, Anita
cceacfe4-1e7c-46ce-94d4-ca778ad9f644
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Grol, Richard
7079ec99-ac2b-4d24-9ddd-513e32814c04
Borm, George
f30d90af-d561-4be6-a156-0903d166a4d1
Adang, Eddy
635fd5d4-2df6-4306-b6b3-9e736ef40253
Hulscher, Marlies
cbd15b6a-6e4d-4831-9c8a-3df23fd53fba
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30

Huis, Anita, Schoonhoven, Lisette, Grol, Richard, Borm, George, Adang, Eddy, Hulscher, Marlies and van Achterberg, Theo (2011) Helping hands: a cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses. Implementation Science, 6, 101-107. (doi:10.1186/1748-5908-6-101). (PMID:21888660)

Record type: Article

Abstract

Background: hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses.

Methods/design: this study is a cluster randomised controlled trial with inpatient wards as the unit of randomisation. Guidelines for hand hygiene will be implemented in this study. Two strategies will be used to improve the adherence to guidelines for hand hygiene. The state-of-the-art strategy is derived from the literature and includes education, reminders, feedback, and targeting adequate products and facilities. The extended strategy also contains activities aimed at influencing social influence in groups and enhancing leadership. The unique contribution of the extended strategy is built upon relevant behavioural science theories. The extended strategy includes all elements of the state-of-the-art strategy supplemented with gaining active commitment and initiative of ward management, modelling by informal leaders at the ward, and setting norms and targets within the team. Data will be collected at four points in time, with six-month intervals. An average of 3,000 opportunities for hand hygiene in approximately 900 nurses will be observed at each time point.

Discussion: performing and evaluating an implementation strategy that also targets the social context of teams may considerably add to the general body of knowledge in this field. Results from our study will allow us to draw conclusions on the effects of different strategies for the implementation of hand hygiene guidelines, and based on these results we will be able to define a preferred implementation strategy for hospital based nursing.

Trial registration: the study is registered as a Clinical Trial in ClinicalTrials.gov, dossier number: NCT00548015

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Published date: 3 September 2011
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 339198
URI: http://eprints.soton.ac.uk/id/eprint/339198
PURE UUID: 7143152c-decc-4d93-a1e5-c0292aab70ec
ORCID for Lisette Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766

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Date deposited: 25 May 2012 08:49
Last modified: 15 Mar 2024 03:41

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Contributors

Author: Anita Huis
Author: Richard Grol
Author: George Borm
Author: Eddy Adang
Author: Marlies Hulscher
Author: Theo van Achterberg

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