A major three-year trial led by researchers at University College London, in partnership with the Health Protection Agency, has shown that giving one-to-one feedback to healthcare workers makes them twice as likely to clean their hands or use soap.
The Feedback Intervention Trial (FIT) is the first such trial to be done in a large number of hospitals anywhere in the world. Carried out across 60 wards in 16 hospitals, the study showed that an intervention that coupled feedback to personalised action planning improved hand-hygiene compliance by up to 18% on Intensive Therapy Units (ITUs) and 13% on Acute Care of the Elderly (ACE) wards. It was also found that soap use increased by 30%.
“This is a landmark trial, as until now there has been no randomised controlled trial evidence showing which interventions improve hand hygiene compliance in modern hospitals,” said principle investigator Dr Sheldon Stone, UCL Medical School at the Royal Free Hospital. “It is also the first trial to use behavioural sciences to change health care workers hand hygiene behaviour.”
The intervention process involved a four-week audit cycle, with healthcare workers observed for 20 minutes. Immediate feedback was given after the period of observation, and the person was then helped to form a personal action plan for better hand hygiene.
In addition to observing and measuring hand-hygiene compliance, the amount of soap and alcohol hand-rub used each month was also collected as another measure of hand-hygiene compliance for each ward. This also gave a better picture of the total weekly usage, as such data was not subject to any observational bias