Implementation and sustainment of a structured hand hygiene group in an oncology hospital: a key factor for improving the hand hygiene performance.

BACKGROUND: Hand hygiene (HH) is central to infection prevention, but evidence from oncology hospitals - where patients are immunosuppressed and strict adherence is critical - remains limited. We aimed to describe the implementation and development of a HH group and its associated activities in an oncology hospital, as well as to evaluate their impact on HH compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. METHODS: This analysis examined long-term trends in HH performance in a tertiary oncology hospital in Brazil (2010-2024), using adherence, ABHR consumption, and HHSAF scores to assess the impact of a multimodal programme. Trend analyses of HH adherence, ABHR consumption, and HHSAF scores over time were performed using linear regression. RESULTS: After the HH group was established in 2013, the programme rapidly progressed to the advanced HHSAF level, accompanied by a significant upward trend in HH adherence (p < 0.01), increasing from a baseline of 26% to 88% in 2022. In contrast, no significant trend was observed for ABHR consumption (p = 0.29), although levels remained consistently above the WHO-recommended threshold. System change was the strongest multimodal component, whereas institutional safety climate remained the weakest. CONCLUSION: Unlike most published studies focused on short-term campaigns or isolated interventions, our work evaluated the real-world sustainability of a WHO-based multimodal programme implemented in routine hospital practice. Sustained improvement was driven by a permanent, structured, multidisciplinary HH group, resulting in long-term advanced HHSAF performance with increasing trends in HH compliance.