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Advancing Infection Prevention: Evidence-Based Strategies for Effective Hand Hygiene

This presentation by Dr. Lesley Price from the Applied Infection Prevention & Control Interventions Programme covers the significant challenges and evidence surrounding hand hygiene practices. It highlights the effectiveness of the WHO 6-step hand hygiene technique, explores various intervention types, and discusses the ongoing PHD projects focused on improving implementation science. The study aims to enhance the understanding of hand hygiene techniques and assesses the contribution of each step in infection reduction, ultimately shaping national and international IPC guidelines.

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Advancing Infection Prevention: Evidence-Based Strategies for Effective Hand Hygiene

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  1. Dr Lesley Price on behalf of: Applied infection prevention & control interventions programme The ‘SHIP’ Research Group (Safeguarding Health through Infection Prevention) Scottish HAI Prevention Institute (SHAIPI) Consortium Infection prevention and control: developing the evidence, challenging the interventions and moving towards implementation science

  2. Overview of presentation: The Problem Our contributions

  3. Evidence for the effectiveness of the WHO 6 step hand hygiene technique

  4. Follow up studies from the 3v6 RCT – could it be how we teach it? 1 year follow up no significant difference in recall of the 6 steps between participants and non-participants. Inconclusive re multimodal or single intervention more effective. Lack of robust design & theoretical underpinning.

  5. Need to think beyond the practitioner what can healthcare facilities and countries do? • Interventions were categorised according to type: multimodal, education, care bundles, policy, surveillance and monitoring and feedback. • Evidence of effectives in all categories but best evidence for multimodal interventions and monitoring and feedback. • Impact • Provided evidence for the WHO Core Components for National IPC guidance.

  6. Next steps: continuing to develop the evidence base for the most effective hand hygiene technique Currently PhD project exploring the contribution of each of the 6 steps in reducing the bacterial load. Currently conducting a systematic review on hand hygiene with regard to volume of product, time and hand size. Developing a CRT comparing normal practice against 3 different adapted 6 step techniques.

  7. Next steps: challenging hand hygiene interventions Currently undertaking study looking at how many days deliberate practice is required before proficiency is developed. • Developing a CRT to test the contribution of each of the 5 components of the WHO multimodal hand hygiene strategy.

  8. Next steps: developing the evidence base for implementation of IPC guidelines • 2 PhD projects evaluating the process of implementing the WHO’s Core Component for IPC Guidelines: • National level in Brazil & Scotland • Hospital level in Uganda

  9. Summary & conclusion: SHAIPI’s predecessor (SIRN) funded a study that initiated this programme of work (3v6 RCT). SHAIPI has facilitated a programme of work bulding on this study by: • Funding a systematic review on hand hygiene techniques • Funding an overview of systematic reviews on hand hygiene interventions • Funding an evaluation of a Guinness World Record • Funding a PhD studentship • Pump priming the Systematic Review on National IPC intervention • Currently funding the Deliberate Practice Study & the development of 2 CRTs.

  10. In addition in recognition of this programme of work GCU has matched funded two other PhD studentships. The work within this programme has been acknowledged by the CDC, WHO & SHEA and changed the WHO’s IPC guidelines. This programme of work is contributing to the evidence base for hand hygiene and other IPC interventions, has had international impact & has and is contributing to IPC research capacity building.

  11. Thank you. Any questions? l.price@gcu.ac.uk

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