Can educational speech intervention improve visitors' hand hygiene compliance?

Background: Hand hygiene, a simple and low-cost measure, remains the leading intervention for reducing the burden related to healthcare-associated infections (HAIs). While many interventions have been tested to improve staff hand hygiene compliance, hospital visitors continue to have low compliance rates, which increases the risk of HAIs and resistant organisms' transmission into hospitals and out to the community.

Aim: To assess the effectiveness of educational speech intervention (ESI) for increasing hand hygiene compliance rate among hospital visitors.

Methods: This interventional study was conducted from March to June 2019 in an inpatient unit of a large academic hospital. Visitor hand hygiene compliance was observed before and after implementation of ESI. The purpose of providing ESI to the visitors in the intervention phase was to remind them about the importance of hand hygiene and the proper method for cleaning hands. Post-intervention data were collected using the survey questionnaires. Unpaired t-test compared the hand hygiene compliance rate before and after the intervention.

Findings: Baseline hand hygiene compliance rate was 9.73% while hand hygiene compliance rate post-intervention increased to 87.06% (P<0.001). Barriers to hand hygiene compliance included occupied hands, improper location of hand hygiene supplies, and past habit of not practising hand hygiene. Visitors preferred to be reminded about hand hygiene by verbal reminder (57%), followed by signage (38%), and wristband notices (5%).

Conclusion: The ESI substantially increased visitors' hand hygiene compliance rate. Further studies are warranted to assess the sustainability of ESI and address other barriers to visitors' hand hygiene compliance.