An Organizational Climate Intervention Associated With Increased Handwashing and Decreased Nosocomial Infections

Abstract

Handwashing practices are persistently suboptimal among healthcare professionals and are also stubbornly resistant to change. The purpose of this quasi-experimental intervention trial was to assess the impact of an intervention to change organizational culture on frequency of staff handwashing (as measured by counting devices inserted into soap dispensers on four critical care units) and nosocomial infections associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). All staff in one of two hospitals in the mid-Atlantic region received an intervention with multiple components designed to change organizational culture; the second hospital served as a comparison. Over a period of 8 months, 860 567 soap dispensings were recorded, with significant improvements in the study hospital after 6 months of follow-up. Rates of MRSA were not significantly different between the two hospitals, but rates of VRE were significantly reduced in the intervention hospital during implementation.

Index Terms:

• enterococcus
• handwashing
• hospitals'
• nosocomial infection
• prevention
• Staphylococcus aureus

Additional information

Notes on contributors

Elaine L. Larson

Dr Larson is Professor of Pharmaceutical and Therapeutic Research at the Columbia University School of Nursing in New York; at the time that this study was conducted, she was dean of the Georgetown University School of Nursing, Washington, DC. Ms Early is director of infection control at Shady Grove Hospital in Rockville, Maryland; Dr Cloonan is an associate professor at the Georgetown University School of Nursing; Ms Sugrue is director of infection control at Georgetown University Hospital; and Dr Parities is an assistant professor of biostatistics at the Columbia University School of Public Health.