ArticleAntimicrobial resistance and infection control2022
Improving hand hygiene practices in two regional hospitals in Kenya using a continuous quality improvement (CQI) approach.
Article in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 14 citations in OpenAlex.
- Hand hygiene compliance among healthcare workers at a tertiary maternity hospital in Sierra Leone: a cross-sectional study.Antimicrobial resistance and infection control · 2026Article
- Implementing a surveillance and prevention program for post-caesarean surgical site infections in Kenya.Antimicrobial resistance and infection control · 2025Article
- Microbial Contamination of Handwashing Water and Tap Surfaces in Addis Ababa Hospitals: A Threat to Infection Prevention.Environmental health insights · 2025Article
- Clinical value of PDCA circulation nursing in reducing nosocomial infection.Frontiers in medicine · 2025Article
- Enhancing infection prevention and control through hand hygiene compliance in six Ugandan hospitals using quality improvement approaches.Frontiers in public health · 2024Article
- Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda.BMJ open quality · 2023Article
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Authors and funding
14 authors at 6 institutions in 2 countries.
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Abstract
backgroundHand hygiene (HH) is central in prevention of health care-associated infections. In low resource settings, models to improve HH compliance are needed. We implemented a continuous quality improvement (CQI) program targeting HH in two hospitals in Kenya.
objectiveTo determine the impact of the HH CQI program and identify factors associated with HH compliance between 2018 and 2019.
methodsA CQI project targeting the improvement of hand hygiene was implemented, including training and mentorship. Data were collected monthly between April 2018 and December 2019 in Thika and Kitale Hospitals. Healthcare workers trained on Infection Prevention and Control (IPC) observed and recorded HH opportunities and subsequent compliance among staff, including nurses, clinicians, and auxiliary staff, using the World Health Organization's "My Five Moments for Hand Hygiene" tool. Covariates were explored using mixed-effects logistic regression with random department-level intercepts.
resultsHand hygiene compliance improved from 27% at baseline to 44% after 21 months. Indication/moment for HH was significantly associated with compliance. Adjusting for site, professional category and department, compliance was higher after a moment of body fluid exposure (aOR 1.43, 95% CI 1.17-1.74, p value < 0.001) and lower before an aseptic procedure (aOR 0.12, 95% CI 0.08-0.17, p value < 0.001) compared to after patient contact. Wearing of gloves often replaced proper HH in surgical departments, which although not significant, had lower compliance compared to departments for internal medicine (aOR 0.93, 95% CI 0.85-1.02). Adjusted HH compliance from all quarters improved from baseline, but comparing each quarter to the previous quarter, the improvement fluctuated over time.
conclusionTraining and mentorship on the importance of HH for all moments is needed to improve overall HH compliance. CQI with regular monitoring and feedback of HH performance can be an effective approach in improving HH compliance in public hospitals in Kenya.
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