The effect of a hand hygiene intervention on infections in residents of nursing homes: a cluster randomized controlled trial

Antimicrobial Resistance & Infection Control

J. M. G. A. Schols¹  M. C. Vos²  D. Nieboer³  V. Erasmus³  G. R. Teesing⁴  J. H. Richardus⁴  H. A. C. M. Voeten⁴  M. P. G. Koopmans⁵  M. Petrignani⁶  A. Verduijn-Leenman⁷ 

[1] Department Health Services Research, CAPHRI, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands;Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;The Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands;Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;Municipal Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands;Pieter Van Foreest, Postbus 118, 2600 AC, Delft, The Netherlands;

关键词: Healthcare associated infections;    Nursing homes;    Hand hygiene;   

DOI  :  10.1186/s13756-021-00946-3

来源: Springer

【 摘 要 】

BackgroundThe primary goal of hand hygiene is to reduce infectious disease rates. We examined if a nursing home’s participation in a hand hygiene intervention resulted in residents having fewer healthcare associated infections (HAIs) when compared to nursing homes without the hand hygiene intervention.MethodsThis study is a part of a cluster randomized controlled trial (RCT) in 33 nursing homes to improve hand hygiene (HANDSOME). The incidence of five illnesses was followed over 13 months: gastroenteritis, influenza-like illness, pneumonia, urinary tract infections and infections from methicillin-resistant Staphylococcus aureus (MRSA). Incidence rates per study arm were reported for baseline (October–December 2016) and two follow-up periods (January–April 2017, May–October 2017). HAI rates were compared in a Poisson multilevel analysis, correcting for baseline differences (the baseline infection incidence and the size of the nursing home), clustering of observations within nursing homes, and period in the study.ResultsThere was statistically significantly more gastroenteritis (p < 0.001) and statistically significantly less influenza-like illness (p < 0.01) in the intervention arm when compared to the control arm. There were no statistically significant differences or pneumonia, urinary tract infections, and MRSA infections in the intervention arm when compared to the control arm. In a sensitivity analysis, gastroenteritis was no longer statistically significantly higher in the intervention arm (p = 0.92).ConclusionsAs in comparable studies, we could not conclusively demonstrate the effectiveness of an HH intervention in reducing HAIs among residents of nursing homes, despite the use of clearly defined outcome measures, a standardized reporting instrument, and directly observed HH in a multicenter cluster RCT. Trial registration Netherlands Trial Register, trial NL6049 (NTR6188). Registered October 25, 2016, https://www.trialregister.nl/trial/6049.

【 授权许可】

CC BY