Hand hygiene (HH) is the most important measure for preventing healthcare-associated infections. A significant correlation between alcohol-based handrub consumption (AHRC) and observed HH compliance rates has been established. In France, publicly reported AHRC displayed a large heterogeneity across healthcare facilities (HCFs). Berthod, et al. (2022) aimed to describe programs for promoting HH in the top and medium AHRC scorers and to assess factors and drivers leading to a high AHRC score in a panel of French HCFs.
The researchers performed a nationwide qualitative comparative case study based on in-depth semi-structured interviews in 16 HCFs with high, 4-year AHRC scores, and a sample of seven university hospitals (UHs) with medium AHRC scores. Infection prevention and control team (IPC) members (n = 62), quality managers/chief executive officers (n = 23) and frontline workers (n = 6) were interviewed, using a grounded theory approach and an iterative thematic approach.
Ninety-one interviews were performed. There was a large heterogeneity in IPC structures and objectives, with specific patterns associated with high AHRC that were more organizational than technical. Four areas emerged: (1) strong cohesive team structure with supportive and outcome-oriented work attitude, (2) IPC structure within the organization, (3) active support from the institution, (4) leadership and role model. Among high AHRC scorers, a good core IPC organization, a proactive and flexible management, a frequent presence in the clinical wards, and working in a constructive safety climate were prominent.
The researchers highlighted that IPC structure and activity is heterogeneous, with organizational and behavioral characteristics associated with high AHRC score. They note, "Beyond technical challenge, our work underlines the importance of strong structure of the IPC and behavioral approaches in implementing key IPC programs."
Reference: Berthod D, et al. Are there reasons behind high handrub consumption? A French National in-depth qualitative assessment. Antimicrobial Resistance & Infection Control. Vol. 11, Article number 42 (2022).