Effect of Education and Performance Feedback on Handwashing in an Argentinean Hospital

BACKGROUND/OBJECTIVES: Patients admitted to hospitals are at risk of acquiring nosocomial infections. Many peer-reviewed studies show that handwashing (HW) significantly reduces hospital infections and mortality rates. Our objective was to evaluate the effects of education and performance feedback on handwashing compliance before contact with patients in an Intensive care Units in a Private Hospital in Buenos Aires City. We performed an observational study of health care workers (HCW) to measure the effect of education alone plus performance feed-back. METHODS: One ICU, of one private hospital was studied for adherence to a handwashing protocol. The observed healthcare workers included physicians, nursing personnel, and ancillary staff. Following initial observations to establish baseline rates of HW (phase 1), we evaluated the effect of education plus performance feed-back (phase 2). RESULTS: Phase one was from October 2003 to May 2004, and phase two was from June 2004 to June 2005. We observed 206 patient contacts during phase one, and 369 during phase two. During phase one, the baseline rate of handwashing before contact with patients was 7.8%, during phase two, with education and performance feedback, handwashing increased to 54.5% (RR 7.01; 95% CI 4.22-11.67; P value: 0.0000). CONCLUSIONS: In this study, HW policies, education, and performance feedback of the HCW significantly improve worker adherence to the handwashing protocol.