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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


MERINO-PLAZA, María José et al. How to increase the health staff adherence to the hands hygiene protocol?. Rev. Esp. Salud Publica [online]. 2018, vol.92, e201810072.  Epub Oct 19, 2018. ISSN 2173-9110.


Nosocomial infection is a frequent adverse event in health care. Hand hygiene (HH) reduces cross-transmission, but staff adhe-rence is not always adequate. The objectives of this work were evaluating the effectiveness of the HH technique applied in the workplace and monitoring the adherence of the healthcare staff of a Hospital of Medium-Long Stay to the HH protocol.


Two cross sectional studies were carried out (2010-2012), to determine the prevalence of colonization of the hands of the staff by pathogenic microorganisms, a cross-sectional study (2015), to evaluate their knowledge of the HH technique and two cross-sectional studies (2015-2016), to evaluate the compliance of the protocol in the healthcare practice. The WHO Self-Assessment Framework was applied annually. The hydroalcoholic solution consumption was monitored as a process indicator.


The prevalence of colonization of the staff hands went from 28.3% to 21.2%. Compliance with hand hygiene went from 39.5% to 72% and the results of the WHO Self-Assessment Framework went from an intermediate level with 287.5 points to an advanced level with 432.5 points. The consumption of hydroalcoholic solution went from 3.9 to 19.3 liters/1000 stays.


Staff adherence to the HH protocol has increased, ha-ving significantly improved the compliance with the recommendations, the hydroalcoholic solution consumption and the HH level assigned to the hospital. The most effective measures to improve the results have been the development of specific improvement plans, having been decisive, the involvement of managers and the use of direct observation as a regular method of work.

Keywords : Hand hygiene; WHO multimodal strategy; Direct observation of compliance of hand hygiene; WHO framework for hand hygiene self-assessment; Alcoholic hand rub.

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