Evaluation of an intervention to improve waterless surgical hand antisepsis accuracy in a tertiary hospital of East China: a prospective pre-post intervention study

Background Surgical site infections (SSIs) are the most frequent type of healthcare-associated infections (HAIs) in low- and middle-income countries (LMICs). Effective surgical hand antisepsis is a critical step in the prevention of SSIs. Limited research on clinician interventions regarding accuracy in waterless surgical hand antisepsis (WSHA) is available. This study evaluated the effect of a tailored, multifaceted improvement strategy on WSHA in a tertiary hospital in East China. We also performed a process evaluation to explore the mechanisms through which our strategy brought about change. Methods A prospective, pre-post intervention study was performed from January 2024 through December in 28 departments. Data from the pre-post intervention studies were collected using a specially designed score checklist and video surveillance (≥4 per department). In addition to the score collection, the mid-term assessment also used a questionnaire that included demographic characteristics and cultural climate surveys. A number of customized interventions were conducted before and after the mid-term assessment. Results The scores of pre-intervention, mid-term assessment, and post-intervention were 71.4 ± 16.8, 92.7 ± 9.2, and 78.7 ± 19.4, respectively. There were statistical differences between the scores of pre-intervention and mid-term assessment ( p < 0.001), mid-term assessment and post-intervention (p < 0.001), and pre-intervention and post-intervention ( p = 0.002). There were statistical differences among different genders, ages, positions, years of working experience, and departments ( p < 0.05). Lower scores appeared in males, orthopedics, and internal medicine. The psychological comfort score was more than 4 points when being reminded to standard WSHA. The number of times the score was less than 2 points was reduced. Conclusion Our interventions have been successful in improving WSHA accuracy. In the future, it will be necessary to closely monitor and supervise WSHA practices to determine the long-term effectiveness of current intervention strategies.