HSR&D Citation Abstract
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Hand Hygiene: VA National Clostridium difficile Infection Prevention Initiative
Schweizer ML. Hand Hygiene: VA National Clostridium difficile Infection Prevention Initiative. [Cyberseminar]. 2013 Mar 26.
Many studies have evaluated bundled interventions to improve hand hygiene compliance.
However, there are few evidence-based recommendations on optimal interventions for
implementation. We aimed to systematically review all studies on interventions to improve hand
hygiene compliance to evaluate existing bundles and identify areas of promise to target high
quality studies. Adjusted risk ratios were pooled to assess common bundles. Of the 8,148
studies evaluated, six randomized controlled trials and 39 quasi-experimental studies met
inclusion criteria. Three studies evaluated the interventions education, reminders, feedback,
administrative support, and access to alcohol-based hand rub [ABHR] as a bundle, which was
associated with improved hand hygiene compliance (pooled odds ratio [OR] = 1.82; 95%
confidence interval [CI] = 1.69, 1.97). Another bundle of education, reminders, and feedback
evaluated in three studies was associated with improved compliance (pooled OR: 1.47; 95% CI:
1.12, 1.94). These bundles should be further studied using high-quality study designs and
compared with other interventions.