[Improved hand hygiene through simple interventions].

Background: On the basis of new National Guidelines for Hand Hygiene, a project was started in 2004 in a medical ward at Haukeland University Hospital. The aims were to improve the personnel's compliance with hand hygiene guidelines and to transfer from soap hand wash to a disinfectant alcohol-based hand rub.

Material And Methods: Two interventions were implemented: information about hand hygiene and increased availability of alcohol-based hand rub. The personnel's hand hygiene performance was recorded through 3 questionnaire-based interviews. The effect was assessed with a paired t-test, by comparing scores 2 and 9 months after the interventions with those before the interventions. Effect was also measured as changes in expenditure on alcohol-based hand rub compared with those for hand soap.

Results: Significant improvements were found for hand hygiene before (p = 0.02) and after (p = 0.01) direct contact with patients, after contact with objects near the patient (p = 0.002), before medicine distribution (p = 0.007) and for two subscores when evaluated after 2 months. The 9-month evaluation maintained most of these results, and for some questions the results improved. The expenditure on hand soap decreased, while the expenditure on alcohol-based hand rub increased significantly from 16 to 26 L/1000 treatment days (p = 0.02). There was little change in the total consumption of hand soap and alcohol-based hand rub.

Interpretation: Information about hand hygiene and increased availability of alcohol-based hand rub led to improved hand hygiene at all levels of staff.