Trial reportAntimicrobial resistance and infection control2020
A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial.
Trial report in Antimicrobial resistance and infection control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review.The Journal of hospital infection · 2021Pooled it
- ATP Bioluminescence Feedback Is Associated with Reduced Residual Hand Contamination Among Healthcare Workers: A Single-Center Before-and-After Study.Healthcare (Basel, Switzerland) · 2026Article
- Longitudinal evaluation of a multimodal hand hygiene intervention in improving healthcare worker compliance: a three-year quasi-experimental study at a cardiac specialty hospital in Karachi, Pakistan.Antimicrobial resistance and infection control · 2026Article
- Infection prevention and control blind spots in education and practice: Qualitative insights from healthcare professionals and healthcare students.Journal of infection prevention · 2025Article
- The Use of Single-Use Medical Gloves in Doctors' Practices and Hospitals.Deutsches Arzteblatt international · 2024Review
- The state of hand rub dispensers in healthcare settings - a multicenter assessment in 19 German healthcare facilities.Antimicrobial resistance and infection control · 2024Article
- Rinse, gel, and foam - is there any evidence for a difference in their effectiveness in preventing infections?Antimicrobial resistance and infection control · 2024Review
- Health Science Students' Perceptions of Hand Hygiene Education and Practice in a South African University: Introducing the University Hand Hygiene Improvement Model.Healthcare (Basel, Switzerland) · 2023Article
- Supporting the Delivery of Infection Prevention and Control Training to Healthcare Workers: Insights from the Sector.Healthcare (Basel, Switzerland) · 2022Article
- Hand Areas Which Are Commonly Missed during Hand Disinfection by Nursing Students Who Completed a Basic Educational Course in Hand Hygiene.International journal of environmental research and public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterventions to improve hand hygiene (HH) compliance are a key element in the practice infection prevention and control. It was our objective to assess the effect of a multimodal intervention on HH compliance at a tertiary care university hospital. As a secondary objective, we investigated the effect of the intervention on the occurrence of device-associated bloodstream infections.
methodsWe performed a single centre cluster randomised controlled trial at a university hospital in Germany. Twenty peripheral wards were invited to participate and randomly assigned to either the intervention (n = 10) or control group (n = 10). Quarterly, specifically trained student employees conducted direct compliance observations in all twenty wards. The intervention entailed dissemination of teaching materials on aseptic procedures, equipment with flexibly mountable alcoholic hand rub dispensers, and quarterly feedback on HH compliance.
resultsIn total, 21,424 HH opportunities were observed. Overall, compliance did not change significantly in either group (intervention group: 59% vs. 61% (1482 HH actions for 2494 HH opportunities vs. 5033 HH actions for 8215 HH opportunities), odds ratio (OR) 1.08 (95% confidence interval (CI95) 0.88, 1.33)); control group: 59% vs. 60% (1457 HH actions for 2484 HH opportunities vs. 4948 HH actions for 8231 HH opportunities), OR 1.06 (CI95 0.84, 1.35)). Compliance prior to aseptic procedures improved significantly in the intervention group from 44% (168 HH actions for 380 HH opportunities) to 53% (764 HH actions for 1452 HH opportunities) (OR 1.40 (CI95 1.04, 1.89), p = 0.03), while no significant increase was noted in the control group. In the intervention group, significantly fewer device-associated bloodstream infections per 1000 patient-days occurred than in the control group (84 vs. 123, incidence rate ratio 0.61 (CI95 0.46, 0.81), p < 0.01).
conclusionsThe lack of a significant overall improvement of HH compliance demonstrated that comprehensive implementation of HH interventions in multiple wards simultaneously is difficult. However, through targeted intervention measures, we were able to significantly increase HH compliance before aseptic procedures.
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