Increase of Alcoholic Hand Rub Consumption in 88 German Hospitals Participating in the National German Hand Hygiene Campaign Since the First 6 Months of 2008

Background:

Hand hygiene is the essential method to prevent hospital acquired infections. The measurement of alcohol-based hand rub consumption (AHC) provides a feasible system of placement and benchmarking between hospitals. The German Krankenhaus-Infektions-Surveillance-System (KISS) established in 2007 a new module for the systematic surveillance of AHC. It is one key element of the German national hand hygiene campaign and providing consumption data to the system is mandatory for campaign hospitals. The German campaign started in January 2008.

Objective:

We compared unit based consumption data for the years 2007 and 2008 of those hospitals, participating in HAND-KISS and the national hand hygiene campaign for at least 6 months in 2008.

Methods:

The following data are provided annually per unit: AHC in ml, the number of annual patient days (PD) per unit and the unit characteristics. HAND-KISS calculates the consumption in ml per PD for individual units and provides reference data stratified according to the specialty of the unit. We examined the data of those units providing consecutive data for 2 years (2007 and 2008). Significance was tested using Wilcoxon test.

Results:

88 hospitals (153 ICUs and 1005 non-ICUs) provided consumption data for the year 2007 and 2008 and participated for at least 6 months in 2008 in the campaign. The ICUs consumed 64.9 ml per PD in 2007 and 74.2 ml per PD in 2008, representing an increase of 12.6%. The non-ICUs used 14.6 ml per PD in 2007 and 16.8 ml per PD in 2008, representing an increase of 15.4%. Overall, the AHC increased by 13% within 1 year (table).

Conclusions:

The national hand hygiene campaign started in January 2008. One key intervention to increase hand hygiene compliance is the mandatory surveillance of AHC for all participating hospitals. HAND-KISS provides reference data of consumption and therefore a system of benchmarking. This is the first system on a national level in Germany. Compared to 2007, the bundle of interventions (e.g. lectures, increase availability of alcoholic hand rub, reminders, national hand hygiene days, yearly meeting of campaigning hospitals, system change) led to an 13% increase of alcoholic hand rub consumption.

Table: Comparison of AHC in 2007 to 2008

		AHC (ml per PD)
type of unit	n	2007 (median)	2008 (median)	Difference (2008-2007) of hospitals (median)	Increase (%) compared to 2007	p-Value
ICU	153	64.9	74.2	8.1	12.6	< 0.05
Non-ICU	1005	14.6	16.8	2.2	15.4	< 0.05
All	1158	23.2	32.7	3	13	< 0.05