Impact of WHO multimodal strategy on hand hygiene in a Tunisian hospital: quasi-experimental study

TL;DR

A study in a Tunisian hospital found that the WHO multimodal strategy slightly improved hand hygiene compliance but had no significant impact on healthcare workers' knowledge.

Contribution

This study evaluates the WHO multimodal strategy's impact on hand hygiene in a Tunisian hospital using a quasi-experimental design.

Findings

Hand hygiene compliance increased significantly from 19.9% to 23.6% after the intervention.

Knowledge of healthcare-associated infection causes improved slightly but not significantly (34% to 40.3%).

Compliance with optimal hand hygiene prerequisites slightly decreased, especially among physicians.

Abstract

The World Health Organization (WHO) multimodal strategy is a globally recognized framework designed to improve hand hygiene (HH) knowledge and compliance among healthcare workers (HCWs). Aim: Assess efficacy of WHO multimodal strategy on healthcare workers’ knowledge and compliance on hand hygiene in a teaching hospital in Tunisia.

A quasi-experimental study with a pre- and post-intervention design was conducted. Baseline data were collected over 4 weeks, followed by a 3-month intervention period and a 4-week post-intervention assessment. To assess knowledge, a Validated WHO questionnaire was used on pre- and post-intervention (scores: 0–100%). To assess HH compliance, the WHO “Five Moments” framework observation was used. Chi-square tests evaluated categorical variables. A p-value <0.05 was considered statistically significant.

Knowledge of major causes responsible for healthcare associated infections passed from 34 to 40.3% (p= 0.19). Awareness of recommended duration of Alcohol-based hand rub or soap and water increased globally (41.8% vs. 49.3%, p=0.29). Concerning HH compliance, global rate significantly increased from 19.9 to 23.6% (p < 10–3). Whereas, the HH compliance rate with optimal respect of the prerequisites was marked by a slight drop overall (from 37.2 to 35.5%, p=0.12), and this drop was particularly noticeable among physicians (from 42.2 to 39.4%).

This study did not conclude on the efficacy of WHO HH strategy on HCWs knowledge. Whereas, a significantly increased HH compliance rate was globally observed.