Hand hygiene compliance in a university hospital - impact of direct observations and feedback and managers’ roles in promoting hand hygiene practices

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu university hospital, auditorium 1

Topic of the dissertation

Hand hygiene compliance in a university hospital - impact of direct observations and feedback and managers’ roles in promoting hand hygiene practices

Doctoral candidate

MSc Helena Ojanperä

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Nursing Science and Health Management

Subject of study

Health management

Opponent

Docent Heljä Lundgrén-Laine, Central Finland Hospital District

Custos

Docent Outi Kanste, University of Oulu

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Hand hygiene compliance in a university hospital - impact of direct observations and feedback and managers’ roles in promoting hand hygiene practices

The purpose of this study was to demonstrate the impact of direct observation and feedback on staff hand hygiene compliance and its impact on the incidence of healthcare-associated infections at a university hospital during an eight-year follow-up. In addition, the managers' roles in promoting hand hygiene were described.
The data consisted of 52,115 hand hygiene observations and confirmed healthcare-associated infections at hospital level from 2013–2018 (publication I) and 31,010 hand hygiene observations and healthcare-associated infections of the corresponding period in six medical and seven surgical wards from 2013–2020 (publication II). Pearson's Correlation Coefficient, Poisson's regression model and logistic regression analysis were used in the data analysis. The open responses to the survey of managers (n=168) were analysed by inductive content analysis (publication III).
The incidence of healthcare-associated infections started to decline at the hospital level when hand hygiene compliance was more than 80% for two years. A weak negative correlation was observed between the increase in hand hygiene compliance and the decrease in the incidence of healthcare-associated infections. In medical and surgical wards, hand hygiene among both nurses and doctors improved in all WHO’s five moments for hand hygiene. During the same period, the incidence of healthcare-associated infections decreased statistically significantly in medical and surgical wards. Managers were committed and promoted hand hygiene in many ways but also identified challenges and presented development ideas.
Last updated: 15.11.2022