Hand hygiene (HH) compliance by healthcare professionals has been recognized as the most important factor in preventing transmission of healthcare-associated infections to patients. Countrywide campaigns have been consecutively organized in Belgian hospitals since 2005 and aim at raising awareness on good HH practices and promoting the use of alcohol based hand rubs. We report here the outcome of the eighth Belgian national hand hygiene campaign organized in 2018-2019.
Each biannual campaign focuses on a specific message taking into account specific findings of the last campaign. The 8th campaign was mainly focused on the importance of hand hygiene in the prevention of bloodstream infections, with the slogan “Hand hygiene, go for zero catheter related sepsis”. The main focus was on the prevention of vascular catheter-related bloodstream infections. This prevention covered both central venous catheter (CVC) and peripheral venous catheter infections. Compliance to hand hygiene guidelines was measured by the infection control teams of participating hospitals by direct observation using a standardized observation roster according to the World Health Organization (WHO). The timeline of the 8th campaign was organized as in previous campaigns: one month pre-campaign compliance measurement (from 05/11/2018 to 04/12/2018), one month of awareness campaign (from 04/02/2019 to 03/03/2019), and one month of post-campaign compliance measurement (from 01/04/2019 to 15/05/2019). The opportunities for hand hygiene were counted and the actual episodes of hand hygiene were scored as hand hygiene with alcohol-based hand rub, hand hygiene with water and soap, or no hand hygiene. Thus, the metric used was the number of episodes divided by the number of opportunities. An online tool (NSIHweb 2.0) was used to collect the individual or aggregated compliance data, with the possibility to obtain immediate feedback. For this eighth campaign, a new feature among the awareness-raising tools proposed was the creation of a “goose game” where patients, caregivers and/or any other participants can compete on the fundamentals of hand hygiene.
A total of a total of 235,026 hand hygiene opportunities were registered (116,167 before and 118,859 after campaign, respectively), retrieved from 152 participating hospitals (sites/mergers; 18 psychiatric hospitals, 12 chronic hospitals, 122 acute hospitals). At the national level, all specialties combined, the compliance (= hand hygiene opportunities with soap and/or alcohol / total number of hand hygiene opportunities observed) was 71.2% (P10: 52.2 ; P50: 73.4 ; P90: 86.8) before the campaign and 79.5% (P10: 68.6 ; P50: 80.6 ; P90: 89.9) after the campaign, representing a pre/post- difference of +8.3%. The Intensive Care Unit (ICU) showed a good score before (76%) and after (80%) campaign (n= 108 units observed) compared to the hospital as a whole. The indication “before venous/arterial contact”, the focus of the eighth campaign, was 76.2% before the campaign and 80% after the campaign. There was therefore an increase in compliance for this indication compared to the result of the seventh campaign (69.2% before and 76.2% after the campaign). As in the previous campaigns, nurses obtained the best results (74.7% before and 82.6% after the campaign).
The eighth national campaign was another success in terms of very high participation rates with a compliance rate that still tends to approach a 80% margin during post-campaign.
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