Patient hand hygiene before meals for infection control

Kamen AS, Mitchell MD, Clark RC, Fonshell C, Holland S, O'Donnell JA, Bass M, Mull NK
Record ID 32018012105
Authors' objectives: Identify and summarize evidence on patient hand hygiene before meals in the management of hospital infections.
Authors' results and conclusions: EVIDENCE SUMMARY •There are multiple interventions related to patient hand hygiene (PHH) before meals. Interventions included patient and staff education, various forms of reminders, directly observed hand hygiene (DOHH), assistance with an ambassador, delivery of hand hygiene products to patients, and hospital policy change. •Hand hygiene recommendations in hospital infection control guidelines are almost all aimed at healthcare workers (HCW), not patients. •There is no evidence of the effects PHH before meals has on clinical infections. The studies identified in this review measured intermediate outcomes (e.g., environmental colonization) and process outcomes (e.g., patient compliance and amount of alcohol-based hand rub (ABHR) used). •DOHH with an ambassador decreased environmental colonization. Ambassadors delivered a pump of sanitizer to each patient before meal tray delivery. Reminders and education are other interventions that increased PHH compliance. These studies are imprecise and pose a risk of bias. The evidence strength is moderate to high. •Multiple hand hygiene interventions can be put together in a bundle. Bundles have a significant effect on PHH compliance. The evidence strength is high. •Confounds in the evidence included; patient population, type of ABHR used, education and other materials used, degree of staff involvement, and outcome measures. No conclusions can be made about the comparative effects without additional evidence.
Project Status: Completed
Year Published: 2024
Requestor: nursing
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: United States
MeSH Terms
  • Hand Hygiene
  • Infection Control
  • Patient Care Bundles
  • healthcare acquired infection
  • infection prevention
  • sanitizer
  • alcohol
  • hand washing
  • environmental colonization
Organisation Name: Penn Medicine Center for Evidence-based Practice
Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104
Contact Name: Nikhil Mull
Contact Email:
Copyright: <p>Center for Evidence-based Practice (CEP)</p>
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