Increase in consumption of alcohol-based hand rub in German acute care hospitals over a 12 year period.

BACKGROUND: Hand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcare-associated infections. In 2007, a voluntary national electronic surveillance tool for the documentation of consumption of alcohol-based hand rub (AHC) was introduced as a surrogate for hand hygiene compliance (HAND-KISS) and for the provision of benchmark data as feedback. The aim of the study was to determine the trend in alcohol-based hand rub consumption between 2007 and 2018. MATERIALS AND METHODS: In this cohort study, AHC and patient days (PD) were documented on every ward in participating hospitals by trained local staff. Data was collected and validated in HAND-KISS. Intensive care units (ICU), intermediate care units (IMC), and regular wards (RW) that provided data during the study period between 2007 until 2018 were included into the study. RESULTS: In 2018, 75.2% of acute care hospitals in Germany (n = 1.460) participated. On ICUs (n = 1998) mean AHC increased 1.74 fold (95%CI 1.71, 1.76; p < .0001) from 79.2 ml/PD to 137.4 ml/PD. On IMCs (n = 475) AHC increased 1.69 fold (95%CI 1.60, 1.79; p < .0001) from 41.4 ml/PD to 70.6 ml /PD..On RWs (n = 14,857) AHC was 19.0 ml/PD in 2007 and increased 1.71 fold (95%CI 1.70, 1.73; p < .0001) to 32.6 ml/PD in 2018. CONCLUSIONS: AHC in German hospitals increased on all types of wards during the past 12 years. Surveillance of AHC is widely established in German hospitals. Large differences among medical specialties exist and warrant further investigation.

Hand Rub Consumption Has Almost Doubled in 132 German Hospitals Over 9 Years.

Annual surveillance data (2007-2015), collected continuously in 132 German hospitals, was evaluated for development of alcohol-based hand-rub consumption (AHC) as a surrogate parameter for hand hygiene adherence. Overall, the median increase in AHC was 94%. The increases over 9 years were significant in all units and quartiles of AHC at baseline. Infect Control Hosp Epidemiol 2017;38:870-872.

The role and utilisation of public health evaluations in Europe: a case study of national hand hygiene campaigns.

BACKGROUND: Evaluations are essential to judge the success of public health programmes. In Europe, the proportion of public health programmes that undergo evaluation remains unclear. The European Centre for Disease Prevention and Control sought to determine the frequency of evaluations amongst European national public health programmes by using national hand hygiene campaigns as an example of intervention. METHODS: A cohort of all national hand hygiene campaigns initiated between 2000 and 2012 was utilised for the analysis. The aim was to collect information about evaluations of hand hygiene campaigns and their frequency. The survey was sent to nominated contact points for healthcare-associated infection surveillance in European Union and European Economic Area Member States. RESULTS: Thirty-six hand hygiene campaigns in 20 countries were performed between 2000 and 2012. Of these, 50% had undergone an evaluation and 55% of those utilised the WHO hand hygiene intervention self-assessment tool. Evaluations utilised a variety of methodologies and indicators in assessing changes in hand hygiene behaviours pre and post intervention. Of the 50% of campaigns that were not evaluated, two thirds reported that both human and financial resource constraints posed significant barriers for the evaluation. CONCLUSION: The study identified an upward trend in the number of hand hygiene campaigns implemented in Europe. It is likely that the availability of the internationally-accepted evaluation methodology developed by the WHO contributed to the evaluation of more hand hygiene campaigns in Europe. Despite this rise, hand hygiene campaigns appear to be under-evaluated. The development of simple, programme-specific, standardised guidelines, evaluation indicators and other evidence-based public health materials could help promote evaluations across all areas of public health.

[Hospital hygiene - Where are we in the sixth year of "Operation Clean Hands"?]. / Krankenhaushygiene - Wo stehen wir im 6. Jahr der "Aktion Saubere Hände"?

The national German hand hygiene campaign is implementing the WHO patient safety initiative "Clean Care is Safer Care". After 6 years over 1400 health care institutions are participating in the campaign on a voluntary basis. The implementation of the multimodal intervention concept including improvement of alcohol based hand rub availability, the introduction of 2 surveillance methods and of the WHO "My 5 Moments of Hand Hygiene Model" in those health care facilities, participating for several years, increased median hand hygiene compliance by 11% and alcohol based hand rub availability by 61%.

Establishment of a national surveillance system for alcohol-based hand rub consumption and change in consumption over 4 years.

Germany established a national surveillance system for alcohol-based hand rub consumption (AHC) in 2008. In 2010, the median AHC was 83 mL/patient-day in 543 intensive care units (ICUs) and 18 mL/patient-day in 4,638 non-ICUs. There was a median increase in AHC of 35.9% (P < .01) in 159 hospitals that participated in the surveillance system for 4 years.

[Clean hands campaign: no chance for healthcare associated infections]. / Krankenhaushygiene--"AKTION Saubere Hände": Keine Chance den Krankenhausinfektionen!

About 500,000 healthcare associated infections can be observed each year in Germany, about 20-30 %, that means 100,000 to 150,000 cases, are avoidable. Healthcare associated infections lead to increased mortality and prolongation of stay. The average prolongation of stay are 4 days, therefore about 2 Million additional hospital days can be determined. In other words about 6 hospitals with 1000 beds each are only caring for patients with healthcare associated infections. Experts agree that careful hand disinfection is the most important procedure to avoid transmission of pathogens. Studies demonstrate that an increasing compliance to hand disinfection leads to a reduction of healthcare associated infections. The clean hands campaign is a joint effort of the National Reference Centre for Surveillance of Nosocomial Infections, the German Society for Quality Management in Healthcare and the Patient Safety Campaign has the objective to achieve a significant improvement of hand hygiene.