Impact of a multicomponent hand hygiene–related intervention on the infectious risk in nursing homes: A cluster randomized trial

•A multifaceted hand hygiene intervention specifically designed for nursing homes was assessed.•Mortality was found to be significantly lower in intervention nursing homes.•No impact was found on hospitalization rates. The aim of this study was to assess the impact of a multifaceted hand hygiene (HH...

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Bibliographic Details
Published in:American journal of infection control 2018-02, Vol.46 (2), p.173-179
Main Authors: Temime, Laura, Cohen, Nadia, Ait-Bouziad, Karim, Denormandie, Philippe, Dab, William, Hocine, Mounia N.
Format: Article
Language:English
Subjects:
Aged, 80 and over
Cross Infection
France
Hand hygiene
Hand Hygiene - methods
Health Personnel
Humans
infection control
Infection Control - methods
Life Sciences
mortality
Nursing Homes
Santé publique et épidémiologie
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Summary:•A multifaceted hand hygiene intervention specifically designed for nursing homes was assessed.•Mortality was found to be significantly lower in intervention nursing homes.•No impact was found on hospitalization rates. The aim of this study was to assess the impact of a multifaceted hand hygiene (HH) program on the infectious risk in nursing homes (NHs). This was a 2-arm cluster randomized trial; French NHs were allocated randomly to the intervention (13 NHs) or control (13 NHs) groups. The intervention consisted of implementing a bundle of HH-related measures over 1 year, including increased availability of alcohol-based handrub, HH promotion, staff education, and local work groups. The primary end point was the incidence rate of acute respiratory infections and gastroenteritis reported in the context of clustered cases episodes. Secondary end points were mortality, hospitalization, and antibiotic prescription rates. Baseline characteristics did not differ between groups. The overall handrub consumption was higher in the intervention group over the 1-year intervention period. Because of underreporting, data on the primary end points were of insufficient quality for analysis. Hospitalizations did not differ between the 2 groups. However, the intervention group showed significantly lower mortality (2.10 vs 2.65 per 100 residents per month, respectively; P = .003) and antibiotic prescriptions (5.0 vs 5.8 defined daily doses per 100 resident days, respectively; P 
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2017.08.030