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Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative

Grayson, M Lindsay, Russo, Philip L, Cruickshank, Marilyn, Bear, Jacqui L, Gee, Christine A, Hughes, Clifford F, Johnson, Paul D R, McCann, Rebecca, McMillan, Alison J, Mitchell, Brett G, Selvey, Christine E, Smith, Robin E and Wilkinson, Irene J 2011, Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative, Medical journal of Australia, vol. 195, no. 10, pp. 615-619, doi: 10.5694/mja11.10747.

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Title Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative
Author(s) Grayson, M Lindsay
Russo, Philip LORCID iD for Russo, Philip L orcid.org/0000-0003-3822-0554
Cruickshank, Marilyn
Bear, Jacqui L
Gee, Christine A
Hughes, Clifford F
Johnson, Paul D R
McCann, Rebecca
McMillan, Alison J
Mitchell, Brett G
Selvey, Christine E
Smith, Robin E
Wilkinson, Irene J
Journal name Medical journal of Australia
Volume number 195
Issue number 10
Start page 615
End page 619
Total pages 5
Publisher AMPCo
Place of publication Sydney, N.S.W.
Publication date 2011-11-21
ISSN 0025-729X
1326-5377
Summary Objective: To report outcomes from the first 2 years of the National Hand Hygiene Initiative (NHHI), a hand hygiene (HH) culture-change program implemented in all Australian hospitals to improve health care workers' HH compliance, increase use of alcohol-based hand rub and reduce the risk of health care-associated infections.

Design and setting: The HH program was based on the World Health Organization 5 Moments for Hand Hygiene program, and included standardized educational materials and a regular audit system of HH compliance. The NHHI was implemented in January 2009.

Main outcome measures: HH compliance and Staphylococcus aureus bacteraemia (SAB) incidence rates 2 years after NHHI implementation.

Results: In late 2010, the overall national HH compliance rate in 521 hospitals was 68.3% (168 641/246 931 moments), but HH compliance before patient contact was 10%-15% lower than after patient contact. Among sites new to the 5 Moments audit tool, HH compliance improved from 43.6% (6431/14740) at baseline to 67.8% (106 851/157 708) (P < 0.001). HH compliance was highest among nursing staff (73.6%; 116 851/158 732) and worst among medical staff (52.3%; 17 897/34 224) after 2 years. National incidence rates of methicillin-resistant SAB were stable for the 18 months before the NHHI (July 2007-2008; P = 0.366), but declined after implementation (2009-2010; P = 0.008). Annual national rates of hospital-onset SAB per 10 000 patient-days were 1.004 and 0.995 in 2009 and 2010, respectively, of which about 75% were due to methicillin-susceptible S. aureus.

Conclusions: The NHHI was associated with widespread sustained improvements in HH compliance among Australian health care workers. Although specific linking of SAB rate changes to the NHHI was not possible, further declines in national SAB rates are expected.
Language eng
DOI 10.5694/mja11.10747
Field of Research 111799 Public Health and Health Services not elsewhere classified
1117 Public Health And Health Services
1103 Clinical Sciences
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, Medical Journal of Australia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089787

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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