Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review

American Journal of Infection Control
June 2016 Volume 44, Issue 6, p619-738, e81-e102

State of the Science Review
Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review
Jun Rong Jeffrey Neo, Rana Sagha-Zadeh, Ole Vielemeyer, Ella Franklin
Published in issue: June 01 2016
:: Five key categories of hand hygiene intervention (HHI) emerged: (1) improving awareness with education (knowledge transfer, evaluation, mentoring and feedback), (2) facility design and planning, (3) unit-level protocols and procedures, (4) institution-wide programs, and (5) multimodal interventions.
:: Although some evidence-based HHI has been developed, sustaining hand hygiene compliance remains challenging.
:: Components like environmental psychology, behavioral economics, and financial rewards should be used to better understand and catalyze improved behavioral change in various contexts and environments to improve hand hygiene.
Hand hygiene (HH) in health care facilities is a key component to reduce pathogen transmission and nosocomial infections. However, most HH interventions (HHI) have not been sustainable.
This review aims to provide a comprehensive summary of recently published evidence-based HHI designed to improve HH compliance (HHC) that will enable health care providers to make informed choices when allocating limited resources to improve HHC and patient safety.
The Medline electronic database (using PubMed) was used to identify relevant studies. English language articles that included hand hygiene interventions and related terms combined with health care environments or related terms were included.
Seventy-three studies that met the inclusion criteria were summarized. Interventions were categorized as improving awareness with education, facility design, and planning, unit-level protocols and procedures, hospital-wide programs, and multimodal interventions. Past successful HHIs may not be as effective when applied to other health care environments. HH education should be interactive and engaging. Electronic monitoring and reminders should be implemented in phases to ensure cost-effectiveness. To create hospitalwide programs that engage end users, policy makers should draw expertise from interdisciplinary fields. Before implementing the various components of multimodal interventions, health care practitioners should identify and examine HH difficulties unique to their organizations.
Future research should seek to achieve the following: replicate successful HHI in other health care environments, develop reliable HHC monitoring tools, understand caregiver-patient-family interactions, examine ways (eg, hospital leadership, financial support, and strategies from public health and infection prevention initiatives) to sustain HHC, and use simulated lab environments to refine study designs.

American Journal of Public Health – Volume 106, Issue 6 (June 2016)

American Journal of Public Health
Volume 106, Issue 6 (June 2016)

Lack of Evidence Supporting the Effectiveness of Disaster Supply Kits
Tara N. Heagele
American Journal of Public Health: June 2016, Vol. 106, No. 6: 979–982.

Human Trafficking and Health: A Survey of Male and Female Survivors in England
American Journal of Public Health: June 2016, Vol. 106, No. 6: 1073–1078.
Siân Oram, Melanie Abas, Debra Bick, Adrian Boyle, Rebecca French, Sharon Jakobowitz, Mizanur Khondoker, Nicky Stanley, Kylee Trevillion, Louise Howard, Cathy Zimmerman
Objectives. To investigate physical and mental health and experiences of violence among male and female trafficking survivors in a high-income country.
Methods. Our data were derived from a cross-sectional survey of 150 men and women in England who were in contact with posttrafficking support services. Interviews took place over 18 months, from June 2013 to December 2014.
Results. Participants had been trafficked for sexual exploitation (29%), domestic servitude (29.3%), and labor exploitation (40.4%). Sixty-six percent of women reported forced sex during trafficking, including 95% of those trafficked for sexual exploitation and 54% of those trafficked for domestic servitude. Twenty-one percent of men and 24% of women reported ongoing injuries, and 8% of men and 23% of women reported diagnosed sexually transmitted infections. Finally, 78% of women and 40% of men reported high levels of depression, anxiety, or posttraumatic stress disorder symptoms.
Conclusions. Psychological interventions to support the recovery of this highly vulnerable population are urgently needed.

Sexual Violence
Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa
American Journal of Public Health: June 2016, Vol. 106, No. 6: 1123–1129.
Margaret Giorgio, Loraine Townsend, Yanga Zembe, Sally Guttmacher, Farzana Kapadia, Mireille Cheyip, Catherine Mathews
Objectives. To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa.
Methods. In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali.
Results. Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87).
Conclusions. Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities.

Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions

BMC Health Services Research
(Accessed 28 May 2016)

Research article
Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions
Barely a decade after introduction of Ghana’s National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services.
Robert Kaba Alhassan, Edward Nketiah-Amponsah, Nicole Spieker, Daniel Kojo Arhinful and Tobias F. Rinke de Wit
BMC Health Services Research 2016 16:192
Published on: 28 May 2016

BMC Infectious Diseases (Accessed 28 May 2016)

BMC Infectious Diseases

(Accessed 28 May 2016)

Research article
Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of potential non-synchronous cessation
The endgame for polio eradication involves coordinated global cessation of oral poliovirus vaccine (OPV) with cessation of serotype 2 OPV (OPV2 cessation) implemented in late April and early May 2016…
Radboud J. Duintjer Tebbens, Lee M. Hampton and Kimberly M. Thompson
BMC Infectious Diseases 2016 16:231
Published on: 26 May 2016

Research article
Gaining and sustaining schistosomiasis control: study protocol and baseline data prior to different treatment strategies in five African countries
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in 2008 to answer strategic questions about schistosomiasis control. For programme managers, a high-priority quest…
Amara E. Ezeamama, Chun-La He, Ye Shen, Xiao-Ping Yin, Sue C. Binder, Carl H. Campbell, Stephen Rathbun, Christopher C. Whalen, Eliézer K. N’Goran, Jürg Utzinger, Annette Olsen, Pascal Magnussen, Safari Kinung’hi, Alan Fenwick, Anna Phillips, Josefo Ferro…
BMC Infectious Diseases 2016 16:229
Published on: 26 May 2016

Research article
Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme
Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV).
Fidele Ngabo, Silvia Franceschi, Iacopo Baussano, M. Chantal Umulisa, Peter J. F. Snijders, Anne M. Uyterlinde, Fulvio Lazzarato, Vanessa Tenet, Maurice Gatera, Agnes Binagwaho and Gary M. Clifford
BMC Infectious Diseases 2016 16:225
Published on: 24 May 2016

Research impact: a narrative review

BMC Medicine
(Accessed 28 May 2016)

Research impact: a narrative review
Trisha Greenhalgh, James Raftery, Steve Hanney and Matthew Glover
BMC Medicine201614:78
DOI: 10.1186/s12916-016-0620-8
Impact occurs when research generates benefits (health, economic, cultural) in addition to building the academic knowledge base. Its mechanisms are complex and reflect the multiple ways in which knowledge is generated and utilised. Much progress has been made in measuring both the outcomes of research and the processes and activities through which these are achieved, though the measurement of impact is not without its critics. We review the strengths and limitations of six established approaches (Payback, Research Impact Framework, Canadian Academy of Health Sciences, monetisation, societal impact assessment, UK Research Excellence Framework) plus recently developed and largely untested ones (including metrics and electronic databases). We conclude that (1) different approaches to impact assessment are appropriate in different circumstances; (2) the most robust and sophisticated approaches are labour-intensive and not always feasible or affordable; (3) whilst most metrics tend to capture direct and proximate impacts, more indirect and diffuse elements of the research-impact link can and should be measured; and (4) research on research impact is a rapidly developing field with new methodologies on the horizon.

Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative

BMC Pregnancy and Childbirth
(Accessed 28 May 2016)

Research article
Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative
Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women.
Melanie E. Gibson-Helm, Alice R. Rumbold, Helena J. Teede, Sanjeeva Ranasinha, Ross S. Bailie and Jacqueline A. Boyle
BMC Pregnancy and Childbirth 2016 16:118
Published on: 24 May 2016

Global Public Health – Volume 11, Issue 5-6, 2016

Global Public Health
Volume 11, Issue 5-6, 2016
Special Issue: Participatory Visual Methodologies in Global Public Health

Participatory visual methodologies in global public health
pages 521-527
Claudia M. Mitchell & Marni Sommer
This Introduction serves to map out a range of participatory visual approaches, as well as critical issues related to the use of participatory visual methodologies in global health. In so doing, it offers both an overview of these innovative practices in global health and a consideration of some of the key questions that researchers might ask themselves in design and implementation.

Research as intervention? Exploring the health and well-being of children and youth facing global adversity through participatory visual methods
pages 528-545
Miranda D’Amico, Myriam Denov, Fatima Khan, Warren Linds & Bree Akesson
Global health research typically relies on the translation of knowledge (from health professionals to the community) and the dissemination of knowledge (from research results to the wider public). However, Greenhalgh and Wieringa [2011. Is it time to drop the ‘knowledge translation’ metaphor? A critical literature review. Journal of the Royal Society of Medicine, 104(12), 501–509. doi:10.1258/jrsm.2011.110285] suggest ‘that while “translation” is a widely used metaphor in medicine, it constrains how we conceptualize and study the link between knowledge and practice’ (p. 501). Often the knowledge garnered from such research projects comes from health professionals rather than reflecting the lived experiences of people and communities. Likewise, there has been a gap in ‘translating’ and ‘disseminating’ the results of participatory action research projects to policymakers and medical practitioners. This paper will look at how using participatory visual methodologies in global health research with children and youth facing global adversity incorporates the multiple functions of their lived realities so that research becomes a means of intervention. Drawing from a literature review of participatory visual methods as media, content and processes of global health research, this paper raises practical, theoretical, and ethical questions that arise from research as intervention. The paper concludes by exploring what lessons emerge when participatory visual methodologies are integrated into global health research with children and youth facing global adversity.

From informed consent to dissemination: Using participatory visual methods with young people with long-term conditions at different stages of research
pages 636-650
Cecilia Vindrola-Padros, Ana Martins, Imelda Coyne, Gemma Bryan & Faith Gibson
Research with young people suffering from a long-term illness has more recently incorporated the use of visual methods to foster engagement of research participants from a wide age range, capture the longitudinal and complex factors involved in young people’s experiences of care, and allow young people to express their views in multiple ways. Despite its contributions, these methods are not always easy to implement and there is a possibility that they might not generate the results or engagement initially anticipated by researchers. We hope to expand on the emerging discussion on the use of participatory visual methods by presenting the practical issues we have faced while using this methodology during different stages of research: informed assent/consent, data collection, and the dissemination of findings. We propose a combination of techniques to make sure that the research design is flexible enough to allow research participants to shape the research process according to their needs and interests.


Beyond engagement in working with children in eight Nairobi slums to address safety, security, and housing: Digital tools for policy and community dialogue
pages 651-665
Claudia Mitchell, Fatuma Chege, Lucy Maina & Margot Rothman
This article studies the ways in which researchers working in the area of health and social research and using participatory visual methods might extend the reach of participant-generated creations such as photos and drawings to engage community leaders and policy-makers. Framed as going ‘beyond engagement’, the article explores the idea of the production of researcher-led digital dialogue tools, focusing on one example, based on a series of visual arts-based workshops with children from eight slums in Nairobi addressing issues of safety, security, and well-being in relation to housing. The authors conclude that there is a need for researchers to embark upon the use of visual tools to expand the life and use of visual productions, and in particular to ensure meaningful participation of communities in social change.