ArticleBMJ open quality2026
Enhancing hand hygiene compliance to reduce healthcare-associated infections in a coronary care unit: a quality improvement initiative in a tertiary hospital in South India.
Article in BMJ open quality, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealthcare-associated infections remain a major concern in critical care environments. Hand hygiene (HH) compliance is a key preventive measure, yet maintaining consistent adherence remains challenging. A quality improvement (QI) initiative was undertaken to enhance HH practices among healthcare providers in a tertiary hospital in South India.
methodsFrom August to December 2023, a QI project was implemented in Coronary Care Units (CCU) at KLE's Dr. Prabhakar Kore Hospital. Using the Point of Care Quality Improvement (PoCQI) methodology, a multidisciplinary team applied WHO's multimodal HH strategy through iterative Plan-Do-Study-Act (PDSA) cycles. Interventions included: (1) installation of centralised scrub stations with sterile footwear, (2) bedside multilingual posters, (3) structured staff training with night-shift monitoring and (4) real-time observation with feedback supported by leadership engagement. Weekly HH compliance and infection outcomes were tracked.
resultsFive PDSA cycles were conducted. Mean HH compliance improved from a baseline of 63.8% to 80.5% by week 20, reflecting a 26.7% relative increase and remained above 78% through week 30, confirming sustained gains postintervention. No methicillin-resistant
conclusionsIntegrating WHO's multimodal strategy with PoCQI led to a significant, low-cost improvement in HH compliance in a high-risk setting. This team-led approach demonstrated the impact of QI strategies in implementing cost-effective infection prevention practices in critical care settings.
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