Interventions to improve healthcare workers’ hand hygiene compliance: a systematic review of systematic reviews

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Original languageEnglish
Pages (from-to)1449-1456
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume39
Issue number12
Early online date11 Dec 2018
DOIs
StatePublished - Dec 2018

Abstract

Aim: To synthesise the existing evidence base of systematic reviews of interventions to improve healthcare workers’ hand hygiene compliance.
Methods: PRISMA guidelines were followed. Ten information sources were searched in September 2017, with no limits to language or date of publication, and papers screened against inclusion criteria for relevance. Data were extracted and risk of bias assessed.
Results: Nineteen systematic reviews (n=20 articles) were included. Only one had a low risk of bias. Fifteen systematic reviews showed positive effects of interventions on healthcare workers’ hand hygiene compliance (n=15), whereas three evaluating monitoring technology did not. Findings regarding whether multimodal than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention was associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.
Conclusions: This is the first systematic review of systematic reviews of interventions to improve healthcare workers’ hand hygiene compliance. There is sufficient evidence to recommend implementation of interventions to improve healthcare workers’ hand hygiene compliance except for monitoring technology but insufficient evidence to make specific recommendations about the content and how the content should be delivered. Future research should rigorously apply behaviour change theory; be clearly described with respect to intervention content and how it is delivered ; and be tested longer-term using stronger study designs with clearly defined outcomes.

Keywords

  • healthcare associated infection, hand hygiene, compliance, healthcare workers, nursing