CHANGES IN PRE-AND POST-INTERVENTION HAND HYGIENE COMPLIANCE IN ICU ON WHO HANDWASHING POSTERS.

Healthcare-associated infections (HAI) cause more deaths in the European Union than all other infectious diseases. Hand hygiene (HH) has been considered the most important means of preventing HAIs but HH compliance is generally less than 50%. One of the five steps that the World Health Organization (WHO) guidelines identify to be specifically implemented are poster reminders. The aim of this study was to evaluate compliance with HH by healthcare workers before and after an intervention on standardized WHO HH poster reminders. An observational one-month study was conducted in a university hospital center surgical intensive care unit. HH compliance was measured through direct observation using WHO observation tool. Intervention was done on day 15 by replacement of standard WHO posters with posters containing a message aimed to call for personal responsibility in patient outcome. A total of 1113 HH opportunities were observed. Overall, HH was performed in 15.4% of cases pre-intervention and 28.3% of cases post-intervention (p<0.001). The preferred method of HH was soap and water. Healthcare workers mostly chose to perform HH after exposure to body fluids, where compliance was 35.1% pre-intervention and 58.7% post-intervention. Gloves were used in 98% of cases of clean/aseptic procedures where HH was not performed. In conclusion, using standard posters to convey additional messages of awareness of consequences and personal responsibility may improve HH and should be considered in multimodal approaches to improve HH compliance.