ArticleAntimicrobial resistance and infection control2022
Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study.
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. An erratum has been issued. Cited by 6 papers.
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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.
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Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- Multimodal Hand Hygiene Interventions and Clinical Healthcare-Associated Infection Outcomes in Acute Care Hospitals: A Systematic Review of Quasi-Experimental Studies.Journal of clinical medicine · 2026Review
- 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
- Assessing the COVID-19 legacy on hand hygiene: Retrospective observational before-after study of compliance and alcohol-based.PLOS global public health · 2026Article
- Article
- Implementing strategies to prevent infections in acute-care settings.Infection control and hospital epidemiology · 2023Article
- Correction: Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study.Antimicrobial resistance and infection control · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
22 authors at 14 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTraditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the "Prevention of Hospital Infections by Intervention and Training" (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect.
methodsWe included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman's rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns.
resultsIn total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18-0.97], and their median HH increase (ρ = 0.79 [0.08-0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance.
conclusionsBoth the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs' overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future.
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