Building an Optimal Hand Hygiene Bundle
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Infectious Disease, Hospital |
| Therapuetic Areas: | Immunology / Infectious Diseases, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/20/2018 |
| Start Date: | October 1, 2014 |
| End Date: | March 1, 2019 |
Building an Optimal Hand Hygiene Bundle: A Mixed Methods Approach
Hand hygiene is the single most effective practice in preventing the spread of
hospital-acquired infections. Despite the strength of the evidence, hospital staff continue
to sanitize their hands less than half of the time required by guidelines. Effective
interventions are needed to improve hand hygiene compliance rates among hospital staff, but
most are of poor quality and do not examine the specific effects of individual interventions.
This study will build a "bundle" of three hand hygiene interventions using a research design
that allows for the effectiveness of each intervention to be measured individually and
combined.
hospital-acquired infections. Despite the strength of the evidence, hospital staff continue
to sanitize their hands less than half of the time required by guidelines. Effective
interventions are needed to improve hand hygiene compliance rates among hospital staff, but
most are of poor quality and do not examine the specific effects of individual interventions.
This study will build a "bundle" of three hand hygiene interventions using a research design
that allows for the effectiveness of each intervention to be measured individually and
combined.
The two specific aims and associated hypotheses of CREATE Project 2 include:
1. Identify combinations of hand-hygiene intervention strategies that optimize hand-hygiene
compliance and that could form an evidence-based hand-hygiene bundle for Veterans Health
Administration (VHA) implementation.
Hypothesis 1: Combinations of interventions will increase compliance rates more than
single interventions.
Aim 1 will entail a 30-month cluster-randomized controlled trial that will sequentially
test three individual hand-hygiene interventions - hand-hygiene point-of-use reminder
signs to serve as an environmental cue to action, individual hand sanitizers, and health
care worker hand cultures - to identify an optimal combination of interventions to
increase hand-hygiene compliance. The trial will be conducted in 59 hospital units in 10
VA hospitals in order to test the efficacy of individual and then sequentially added
interventions to determine their incremental impact on hand-hygiene compliance.
The focus for this clinical trial will be on Aim 1--Single Hand Hygiene Sign changes.
2. Identify institutional, organizational, ward/ICU, and individual level facilitators and
barriers to implementing hand-hygiene interventions.
Hypothesis 2: Facilitators and barriers will pattern around contextual factors such as level
of leadership support and organization of infection control programs.
Aim 2 will entail a qualitative process evaluation that includes site visits to purposefully
selected sites, semi-structured interviews, and observations to examine barriers and
facilitators to the interventions and develop contextual insight for implementing and
scaling-up the intervention at additional sites as a national initiative.
1. Identify combinations of hand-hygiene intervention strategies that optimize hand-hygiene
compliance and that could form an evidence-based hand-hygiene bundle for Veterans Health
Administration (VHA) implementation.
Hypothesis 1: Combinations of interventions will increase compliance rates more than
single interventions.
Aim 1 will entail a 30-month cluster-randomized controlled trial that will sequentially
test three individual hand-hygiene interventions - hand-hygiene point-of-use reminder
signs to serve as an environmental cue to action, individual hand sanitizers, and health
care worker hand cultures - to identify an optimal combination of interventions to
increase hand-hygiene compliance. The trial will be conducted in 59 hospital units in 10
VA hospitals in order to test the efficacy of individual and then sequentially added
interventions to determine their incremental impact on hand-hygiene compliance.
The focus for this clinical trial will be on Aim 1--Single Hand Hygiene Sign changes.
2. Identify institutional, organizational, ward/ICU, and individual level facilitators and
barriers to implementing hand-hygiene interventions.
Hypothesis 2: Facilitators and barriers will pattern around contextual factors such as level
of leadership support and organization of infection control programs.
Aim 2 will entail a qualitative process evaluation that includes site visits to purposefully
selected sites, semi-structured interviews, and observations to examine barriers and
facilitators to the interventions and develop contextual insight for implementing and
scaling-up the intervention at additional sites as a national initiative.
Inclusion Criteria:
- Wards/units at 10 VA medical centers ( 1. hand hygiene observations of healthcare
works on these wards/units, 2. MRSA rates on each ward/unit as documented in patient
electronic medical record)
- Health Care Workers (HCWs), Hospital Epidemiologists, Infection Control Professionals,
and MRSA/Multi-Drug Resistance Organism (MDRO) Coordinators (Aim 2)
Exclusion Criteria:
We found this trial at
10
sites
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Baltimore, Maryland 21201
Phone: 410-605-7000
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Boston, Massachusetts 02130
Phone: 617-232-9500
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Omaha, Nebraska 68105
Phone: 402-346-8800
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Salt Lake City, Utah 84148
Phone: 801-582-1565
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