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This study aims to evaluate the effectiveness of a multimodal hand hygiene improvement strategy, enhanced with information technology (IT), in reducing healthcare-associated infections (HAIs) in nursing homes. The goal is to improve infection prevention practices and promote a safer environment for older adults living in long-term care facilities.
Hand hygiene is a key strategy for preventing healthcare-associated infections (HAIs), yet compliance among healthcare workers remains suboptimal due to knowledge gaps, limited resources, unfamiliarity with procedures, and poor adherence. This study aims to assess the effectiveness of an IT-enhanced multimodal hand hygiene intervention in reducing HAIs within nursing homes, thereby improving infection control practices and promoting a safer environment for older adults in long-term care settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | Experimental | received a three-month IT-enhanced program. |
|
| Control group | No Intervention | Continued routine care and only took part in the same measurements |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multimodal Information Technology-based Hand Hygiene Strategies | Other | The intervention, adapted from the WHO's multimodal strategy, incorporated IT-based components to enhance hand hygiene compliance. A one-time, 1-hour online education session via Google Meet covered the WHO's Five Moments and seven-step handwashing technique, with real-time feedback using fluorescent dye and UV light. Post-session videos were available on tablets for review. Visual reminders, such as screensavers and digital posters, reinforced learning. Smart sanitizer dispensers with seven-step lights and a 20-second countdown were installed at five key sites, RFID-linked to staff badges for automatic tracking. Monthly performance data were shared via bulletin boards and LINE, with SMS feedback to top and bottom performers. Daily audio reminders played at 9 a.m. and 5 p.m., and high performers were recognized in monthly meetings. |
| Measure | Description | Time Frame |
|---|---|---|
| Hand Hygiene Knowledge | Cognitive scores were obtained through a "Hand Hygiene Knowledge Questionnaire for Long-term Care Facility Workers" It comprised 15 items (12 true/false, 2 multiple-choice, 1 multiple-answer), awarding 1 point for each correct answer and 0 for incorrect or unsure response, with a total score ranging from 0 to 15. Higher scores indicated greater hand hygiene knowledge. | 1 month |
| Hand hygiene Compliance Rates | Hand hygiene compliance data were collected using the "Hand Hygiene Compliance Rate and Behavior Inspection Checklist for Long-term Care Facility Workers"(%) | 4 month |
| Hand hygiene Accuracy Rates | Hand hygiene Accuracy data were collected using the "Hand Hygiene Compliance Rate and Behavior Inspection Checklist for Long-term Care Facility Workers"(%) | 4 month |
| Density of healthcare-associated infections | A facility's "density of HAI" followed Taiwan's Centers for Disease Control (2012) guidelines(‰) | 4 month |
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Inclusion Criteria:
Exclusion Criteria:
• Confirmed or anticipated resignation
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kaohsiung Nursing Home | Kaohsiung City | Taiwan | ||||
| Pingtung Nursing Home |
for personal privacy reason
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 27, 2022 | Apr 27, 2025 |
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|
| Pingtung City |
| Taiwan |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 27, 2022 | Apr 27, 2025 | SAP_001.pdf |
| ID | Term |
|---|---|
| D010349 | Patient Compliance |
| D003428 | Cross Infection |
| ID | Term |
|---|---|
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
| D007239 | Infections |
| D007049 | Iatrogenic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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