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Tue 1 May 2007 04:41 PM

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No quick fix on hygiene

Cochrane Collaboration investigators evaluating studies on hand hygiene among healthcare professionals have concluded that few strategies to boost sanitation are effective.

Cochrane Collaboration investigators evaluating studies on hand hygiene among healthcare professionals have concluded that few strategies to boost sanitation are effective.

There has been a considerable increase in the number of studies looking at various tactics to improve hygiene, but "the evidence base remains poor," according to Dinah Gould, Ph.D., of City University's School of Nursing and Midwifery.

Only two studies were deemed reliable enough for inclusion in the literature search.

The two studies were randomised controlled trials from China (Huang et al. in 2002) and a controlled before-and-after study from London (led by Dr. Gould in 1997). Both evaluated a single intervention involving education relating to universal precautions as well as hand hygiene.

In the Chinese study, the researchers randomised 100 nurses to experimental and controls groups. The experimental group was given two hours of formal teaching about hygiene precautions, an hour of practical demonstration, 30 minutes of discussion, and written information.

Four months later, the study found that the intervention significantly improved hand-washing among the nurses in the experimental group.

Gould et al selected two surgical units to act as the experimental group and matched them with two control units. Nurses on the experimental units were given five different half-hour sessions on infection control, along with practical demonstrations.

Three months post-intervention the number of essential hand washes was similar in the intervention and control groups, the researchers found.

The chief conclusion is that "soundly designed studies are urgently required," Gould and colleagues wrote.

"We desperately need some good research that will begin to show which interventions can bring about change in people's behaviour that will lead to increased hand hygiene," the team added.

"Good hand hygiene forms an important indicator of the quality of health care and should continue to be promoted in all clinical settings," they concluded.

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