TABLE 11.

Compliance rates in hand hygiene, according to the agent and intervention

Type of ward(s)Agent(s)a (baseline)Main active agent(s)a (new)Intervention(s)Compliance rate (%)Main reason(s) for changeReference
BaselineAfter intervention
ICUSoapSoapLectures, feedback, demonstrations563Lectures, feedback, demonstrations51
ICUSoapSoapNew design of ICU1630More convenient sink location446
ICUSoapSoapEducation22.029.9Education518
ICUSoapSoapLectures and reminder labels on ventilators46 (before patient contact), 83 (after patient contact)92 (before patient contact), 92 (after patient contact)Lectures and reminder labels on ventilators264
Pediatric ambulatory settingSoapSoapUse of reminders4949Use of reminders324
Pediatric wardsSoapSoapEducational program5274Educational program31
Emergency departmentSoapSoapPosting of signs, education5464Posting of signs, education120
Neonatal ICUSoapSoapUse of gowns6260Use of gowns421
ICUSoapSoapPerformance feedback and new soap6392Performance feedback352
ICUSoapSoapEducation and feedback8192Education and feedback122
Surgical ICUPlain and medicated soap (chlorhexidine)Plain and medicated soap (chlorhexidine)Automatic hand-washing machines available2238Availability of hand-washing machines618
New-burn nursersiesMedicated soapMedicated soapFeedback2863Feedback451
Medical ICUMedicated soapMedicated soapRoutine wearing of gowns and gloves, educational meetings40.858.2Routine wearing of gowns and gloves, educational meetings521
ICUMedicated soap (para-chloro- metaxylenol)Medicated soap (para-chlorometaxylenol)Teaching and reminders (buttons)2229.9Reminders518
Medical ICUMedicated soap (4% chlorhexidine)Medicated soap (4% chlorhexidine)Education26% (before patient contact), 23% (after patient contact)38% (before patient contact), 60% (after patient contact)Education91
Pediatric ICUSoap (plain and medicated), ethanol (70%), aqueous povidone iodineSoap (plain and medicated), ethanol (70%), aqueous povidone iodineOvert observation and feedback12% (before patient contact), 11% (after patient contact)68% (before patient contact), 65% (after patient contact)Overt observation and feedback559
ICUSoapEthanol (60%)Quality improvement and introduction of hand gel42.535.1“Sticky uncomfortable feeling” of product197
ICU and medical wardPlain and medicated soap (4% chlorhexidine)Ethanol (60%)Education program followed by introduction of hand rub16.320.9 (after education), 33.2 (after introduction of hand rub)Easy access of hand rub63
Medical ICU and wardSoapEthanol (62%)Introduction of hand rub with an educational and motivational campaign; wall dispensersOverall, 60%; medical ICU, 70.3%; ward, 46.2%Overall, 52%; Medical ICU, 58%; ward, 48%Physicians as role models388
Plastic surgery departmentSoapEthanol (70%)Performance feedback6261.3Performance feedback336
Neonatal ICUPlain soapEthanol (79%)Introduction of hand rub and quality improvement4448Unknown75
ICUSoapIsopropanol (60%)Introduction of hand rub and teaching3245Accessability of hand rub180
ICUPlain soapIsopropanol (75%)Promotion campaign for hand hygiene38.454.5Campaign on benefits of alcohol-based hand rubs223
AllIsopropanol (75%)Promotion campaign for hand hygiene4866Campaign on benefits of alcohol-based hand rubs439
Medical ICUPlain soapIsopropanol (45%) and n-propanol (30%)Introduction of hand rub and education42.260.9Availability of hand rub; short time for hand rub procedure351
AllSoap (plain and medicated)Isopropanol (45%) and n-propanol (30%)Introduction of hand rub and education62.266.5Better dermal tolerance of hand rub167
AllSoap (plain and medicated)Isopropanol (45%) and n-propanol (30%)Introduction of hand rub and education5266Dermal tolerance and accessibility169
  • a “Soap” was always assumed to be meant when “hand washing” was mentioned in a study; it may include plain and medicated soap.