BACKGROUND Hung Vuong Hospital (HVH) is a 900-bed maternity hospital in Ho-Chi-Minh-City, Vietnam. Due to low compliance, a quasi-experimental, observational study was conducted with the aim to improve hand hygiene. METHODS A multimodal promotion strategy was established in 2010 and further developed towards ongoing, repetitive and inventive campaigns including patient participation. Hand hygiene compliance was monitored by direct observation and healthcare-associated infections (HAIs) by applying standard definitions. RESULTS Between 2010 and 2018, a total of 43,711 hand hygiene opportunities were observed. Compliance improved from 21.5% (95%CI: 20.2-22.8%) in 2010 to 75.1% (73.9-76.2%) in 2018 (incidence rate ratio, IRR , 1.10; 95%CI, 1.10-1.11). This was achieved through increasing recourse to alcohol-based hand rubbing. A total of 554,720 women were admitted to HVH during the study period for 353,919 deliveries (198,679 vaginal; 155,240 by C-section) and 257,127 surgical procedures. The HAI-incidence decreased significantly from 1.10 episodes per 1000 patient-days in 2010 to 0.45 per 1000 patient-days in 2018 (IRR 0.85; 95%CI, 0.79-0.90). Significant improvement was observed also for surgical site infections after gynaecological surgery (IRR 0.95; 95%CI, 0.92-0.99) and endometritis after abortion (IRR 0.80; 95%CI, 0.68-0.93). CONCLUSIONS A multimodal strategy aiming at behaviour change significantly improved and sustained hand hygiene, which contributed to the reduction of healthcare-associated infections.

中文翻译：

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越南大型妇科/产科三级护理中心旨在改善手部卫生状况对依从性和医疗保健相关感染的多模式运动的持续效果。

背景技术洪武医院（HVH）是位于越南胡志明市的900张病床的妇产医院。由于依从性较低，因此进行了一项准实验性观察研究，目的是改善手部卫生状况。方法2010年制定了多模式促进策略，并针对包括患者参与在内的持续，重复和创造性运动进行了进一步发展。通过直接观察和采用标准定义的医疗保健相关感染（HAIs）监控手的卫生状况。结果2010年至2018年期间，共观察到43711手卫生的机会。合规性从2010年的21.5％（95％CI：20.2-22.8％）提高到2018年的75.1％（73.9-76.2％）（发生率比率IRR为1.10; 95％CI为1.10-1.11）。这是通过增加对酒精基手摩擦的依赖来实现的。总共554 在研究期间，有720名妇女接受了HVH治疗，分娩353,919例（阴道198,679例；剖腹产155,240例）和257,127例手术。HAI发生率从2010年的每1000个患者日1.10次发作显着下降到2018年的每1000个患者日0.45次（IRR 0.85; 95％CI，0.79-0.90）。妇科手术后的手术部位感染（IRR 0.95； 95％CI，0.92-0.99）和流产后子宫内膜炎（IRR 0.80； 95％CI，0.68-0.93）也观察到显着改善。结论针对行为改变的多模式策略可显着改善和保持手部卫生，从而有助于减少与医疗保健相关的感染。HAI发生率从2010年的每1000个患者日1.10次发作显着下降到2018年的每1000个患者日0.45次（IRR 0.85; 95％CI，0.79-0.90）。妇科手术后的手术部位感染（IRR 0.95； 95％CI，0.92-0.99）和流产后子宫内膜炎（IRR 0.80； 95％CI，0.68-0.93）也观察到显着改善。结论针对行为改变的多模式策略可显着改善和保持手部卫生，从而有助于减少与医疗保健相关的感染。HAI发生率从2010年的每1000个患者日1.10次发作显着下降到2018年的每1000个患者日0.45次（IRR 0.85; 95％CI，0.79-0.90）。妇科手术后的手术部位感染（IRR 0.95； 95％CI，0.92-0.99）和流产后子宫内膜炎（IRR 0.80； 95％CI，0.68-0.93）也观察到显着改善。结论针对行为改变的多模式策略可显着改善和保持手部卫生，从而有助于减少与医疗保健相关的感染。