Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study

Abstract

The study aimed to evaluate the efficacy of the World Health Organization (WHO) multimodal hand hygiene improvement (WHO-5) strategy in enhancing hand hygiene compliance among health care workers at a tertiary care hospital. The interrupted time series study included preintervention, intervention, and postintervention phases, with 2 points of observation each during the pre- and postintervention phases. The baseline hand hygiene compliance was 16%, which improved to 43.9% after the intervention. Health care workers were 4 times more likely to adhere to proper hand hygiene postintervention (odds ratio [OR], 4.117). Independent predictors of hand hygiene compliance included the week of observation (week 3: adjusted odds ratio [AOR], 0.872; week 5: AOR, 3.427; and week 7: AOR, 4.713), health care worker type (consultants: AOR, 0.964; residents: AOR, 2.187; and interns: AOR, 6.684), daytime (AOR, 1.232), and “after” type of hand hygiene opportunity (AOR, 1.577). No significant differences were found in knowledge, attitude, and practices pre- and postintervention, and the interventions’ effect was sustained and increased over time, supporting implementation in hospitals across India.