Implementation of a Multimodal Multicentre Hand Hygiene Study: Evidence From Bangladesh Hospitals

  •  Lutfe Ara    
  •  Monisha Datta Trisha    
  •  Md. Ehsanul Haque Tamal    
  •  Noor Kutubul Alam Siddiquee    
  •  SM Niaz Mowla    
  •  Fahima Hossain    
  •  Tarannum Rahman    
  •  Md. Shafiqul Alam Sarker    
  •  Md. Nur Haque Alam    


INTRODUCTION: Hand hygiene (HH), one of the most important preventive measures of Healthcare-associated infections (HCAIs), is often neglected by healthcare workers (HCWs) in low and middle-income countries (LMICs).

PURPOSE: The purpose of the study is to assess the role of a multimodal intervention (MMI) for enhancing hand hygiene compliance (HHC) of HCWs in a resource-limited setting.

METHODOLOGY: A pretest-posttest quasi-experimental study was conducted in five hospitals of Bangladesh where 984 HCWs (342 physicians and 642 nurses) were selected purposively. Using a structured checklist, a direct observational assessment was carried out on HCWs’ HHC both before and after the intervention. The MMI provided to HCWs comprised of: (i) system change, (ii) educational intervention, (iii) visual reminders, (iv) monitoring and performance feedback and (v) formation of infection control committees.

RESULTS: Following intervention, overall HH compliance before and after patient contact significantly increased (p<0.00) to 50.1% and 57.2% respectively across all hospitals, professional categories and activities. Nurses were more compliant to HH than physicians (OR = 1.1, 95% CI: 1.0-1.3, P < 0.01) after patient contacts. However, both groups showed equal HHC (OR = 1, CI: 0.9-1.1, P = 0.72) before patient contacts. HCWs of private hospitals were 1.5 times more compliant to HHC than that of public hospitals.

CONCLUSIONS: This study denotes that despite national policies on hand hygiene in Bangladesh, HCW’s compliance to HH is poor. Study findings also illustrate that a multimodal HH program resulted in significant improvement in HCWs’ HHC that deserves the potentials to assist the advancement of infection control practices targeting reduction of HCAIs.

This work is licensed under a Creative Commons Attribution 4.0 License.