![]() In this part, we did a questionnaire survey on possible factors affecting HH behaviors of HCWs. We performed this two-part quasi-experimental study including questionnaire survey of factors affecting HH behaviors of HCWs and direct observation of compliance and correctness with HH before and after intervention. This hospital has 1001 beds in 27 clinical departments including acupuncture and moxibustion, intensive care, emergency, surgical and TCM subspecialties with 1377 HCWs. It is the largest public hospital in north Xi’an, which is the capital city of Shaanxi Province. The study was conducted in Xi’an Hospital of Traditional Chinese Medicine (TCM), Xi’an, China, between September 2015 and August 2016. We initiated this study of implementation of WHO multimodal HH strategy in order to improve awareness of HAI and enhance HH compliance and correctness among HCWs. However, there have been few data on the implementation of the WHO multimodal HH strategy in China. It has been demonstrated the implementation of WHO HH strategy is feasible and effective to enhance hand hygiene compliance, which leads to a reduction of HAI. The World Health Organization (WHO) launched a multimodal strategy in 2009 to improve HH practice worldwide, which includes 5 important components: (1) system change, (2) training and education, (3) evaluation and feedback, (4) reminders in the workplace (5) institutional safety climate. The hands of healthcare workers (HCWs) can be a major mode of transmission of microbial pathogens by touching the environment or patients’ skin during healthcare delivery, which supports that hand hygiene (HH) is a critical component of a bundle approaches for preventing and controlling HAIs. A recent study in China identified that the average cost of hospitalization increased ¥13,839.16(€1792.64) due to HAI. HAI resulted in prolonged length of hospital stay, direct economic loss, morbidity and mortality among hospitalized patients. According to the survey of National HAI Surveillance System, in 2014, at least 26,972 cases of HAI arose in patients admitted to hospital in China. Healthcare-associated infection (HAI) represents a major burden and safety issue for patients in the developing countries, with severe and greatly underestimated effect on patients and health care systems. Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs. ![]() When stratified by indication, compliance with HH improved for all indications after intervention ( P < 0.05) except for “after body fluid exposure risk” and “after touching patient surroundings”. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. A total of 5044 observations in 23 wards were recorded in this investigation. In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. Also HH practices for different indications based on WHO “My Five Moments for Hand Hygiene” were recorded. Compliance and correctness with HH among HCWs were compared before and after intervention. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. MethodsĪ quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). ![]() Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. ![]()
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