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Association of national and hospital factors to hospitals' alcohol-based handrub consumption in Europe: results of the European PROHIBIT study

Hansen, S, Schwab, F, Gastmeier, P , Zingg, W, Pittet, D., Sax, P., Grundmann, H., van Benthem, B., van der Kooi, T., Dettenkofer, M., Martin, M., Szilagyi, R. E., Kozpont, O. E., Heczko, P. B., Holmes, A., Kyratsis, Y. ORCID: 0000-0002-5185-7413, Ahmad, R., Allegranzi, B., Magiorakos, A., Cookson, B. & Wu, A. W. (2018). Association of national and hospital factors to hospitals' alcohol-based handrub consumption in Europe: results of the European PROHIBIT study. Clinical Microbiology and Infection, 24(7), 778.e1-778.e6. doi: 10.1016/j.cmi.2017.10.015


OBJECTIVES: Hand hygiene is considered the most effective way to reduce the transmission of (multidrug-resistant) organisms and to prevent healthcare-associated infections. Hand rubbing with alcohol-based handrub (AHR) has become the reference standard for hand hygiene. Data on AHR consumption are easy to obtain and can serve as an approximation for hand hygiene compliance. As described earlier, AHR consumption varies among European hospitals. In the current study the role of various hospital and country indicators for AHR consumption is analysed.

METHODS: As part of the European Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project hospital-based data on infection prevention and control (IPC) structure and organization and hospital-wide AHR consumption were obtained from acute care hospitals. National indicators such as income, public health expenditure, national hand hygiene campaigns, IPC training and the six Hofstede dimensions were identified. Univariable and multivariable linear regression analyses using generalized linear models were performed to estimate the association between AHR consumption and indicators at both hospital and country levels.

RESULTS: Data from 232 hospitals from 22 European countries were analysed. Multivariate risk factor analysis showed independent associations between AHR consumption and private and university-affiliated hospitals (multiplicative effect, 95% CI: 1.76, 1.21-2.55; and 1.39, 1.17-1.64, respectively), high-income countries (3.61, 2.94-4.43), and countries offering national curricula for the training of IPC nurses (3.77, 2.32-6.13). However, no cultural dimension was independently associated with AHR consumption.

CONCLUSION: Country indicators such as high-income, national training on IPC, and hospital type and status are positively associated with AHR consumption in Europe.

Publication Type: Article
Additional Information: © Elsevier 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Publisher Keywords: Acute care hospitals, Europe, Hand hygiene, Healthcare-associated infections, Prevention
Subjects: R Medicine > RA Public aspects of medicine
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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