Major articleDissemination of the CDC's Hand Hygiene Guideline and impact on infection rates
Section snippets
Sample and setting
The sample for this study was obtained from among hospitals that were members of The National Nosocomial Infections Surveillance (NNIS) System, a national reporting network of >300 acute care hospitals representing nearly every state and coordinated by the CDC. The NNIS is the largest and most comprehensive reporting system for HAI in the world9 and has recently been incorporated into the National Healthcare Safety Network (http://www.cdc.gov/ncidod/hip/NNIS/members/members.htm, accessed July
Characteristics of the study hospitals
Among the 40 study hospitals, 75% were in the eastern region of the United States, and 60% were affiliated with an academic health center. The mean number of active beds of participating hospitals was 417, with 10% having 100 to 199 beds, 40% having 200 to 399 beds, and 50% having ≥400 beds. There were 71 ICUs in the study hospitals, including 30 medical-surgical (42%), 18 medical (25%), 13 surgical (18%), and 10 pediatrics (14%). Most infection control directors (85%) had ≥9 years of
Implementation and compliance with Guideline recommendations
The Hand Hygiene Guideline was widely disseminated in all 40 study hospitals, the majority of staff members were familiar with it, and alcohol hand hygiene products were readily available. Implementation scores were high, with a median of 10.5 out of a total possible of 12, but these scores primarily measured “structural” and “process” factors such as the presence of appropriate products on clinical units and the conduct of staff educational programs. Fewer than half of hospitals had
Conclusion
Although the CDC Hand Hygiene Guideline was widely disseminated and hospitals responded by changing written policies and procedures as well as providing recommended products, this was insufficient to effect a change in clinician practice; compliance with hand hygiene recommendations remained low. Many hospitals had no multidisciplinary program or staff feedback mechanisms to improve compliance despite the Guideline recommendation and the fact that such programs have proven effective in other
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Supported by The National Institutes of Health, National Institute of Nursing Research, Impact of Hand Hygiene Guideline on Infections and Costs, 1 RO1 NR008242.