Hand hygiene is globally recognized as one of the essential measures for the control and prevention of healthcare-associated infections (HAIs), and multimodal intervention is one of the strategies recommended to improve hand hygiene practices among healthcare professionals. HAIs are associated with increased mortality, prolonged hospital stay, and higher costs. To evaluate the impact of a multimodal intervention on hand hygiene adherence, HAI density, and HAI-associated mortality rate. Quasi-experimental study conducted in six adult ICUs in the Greater São Paulo area, developed in three periods: pre-intervention (08/01/23–10/31/23), multimodal intervention (11/01/23–04/31/24), and post-intervention (05/01/24–10/31/24). During the first period, professionals maintained their usual hand hygiene practices. During the intervention, training sessions were conducted, educational videos and leaflets were provided, supplies for hand hygiene practice were made available (one alcohol-based hand rub bottle per bed), feedback was given on hand hygiene practice evaluations, and reminder posters were posted in the units. In the post-intervention period, the implemented measures were maintained. Hand hygiene practice was considered “compliant” when the action was performed according to the five moments for hand hygiene recommended by the World Health Organization, with no use of adornments. Observations were conducted by the same observers throughout the study. HAIs were reported according to the diagnostic criteria of the Agência Nacional de Vigilância Sanitária by the same infection control specialist throughout the study. Death was considered HAI-related when it occurred within 30 days of the HAI notification date. A total of 5,297 hand hygiene assessments were performed. Mean adherence rates by study period were 56.67% (n = 869), 62.5% (n = 1,895), and 80.33% (n = 2,533), respectively (p < 0.05). The mean global HAI density per 1,000 patient-days by study period was 9.93, 8.05, and 7.43 (p = 0.02). The mean HAI-associated mortality rate was 2.52%, 4.52%, and 2.52%, respectively (p = NS). The multimodal intervention contributed to increased hand hygiene adherence among healthcare professionals and favored a reduction in the global HAI density, without altering the HAI-associated mortality rate.
Matias et al. (Sun,) studied this question.