BACKGROUND Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a "Train-the-Trainers" (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. METHODS We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. RESULTS Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. CONCLUSIONS The TTT in hand hygiene model proved to be effective in enhancing participant's knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.

中文翻译：

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手卫生培训师培训：指导感染预防和控制教育的标准化方法。

背景 感染预防和控制 (IPC) 专业人员的手部卫生培训缺乏统一性。我们描述了一种标准化的培训方法，对 IPC 专业人员使用“培训师培训”(TTT) 概念，并评估其对六个国家手卫生知识的影响。方法 我们根据世界卫生组织 (WHO) 多模式手部卫生改进策略开发了一个为期三天的基于模拟的 TTT 课程。为了评估其影响，我们进行了课前和课后知识问卷调查。Wilcoxon 符号秩检验用于比较训练前后的结果。结果 2016 年 6 月至 2018 年 1 月期间，我们在六个国家/地区举办了七期 TTT 课程：伊朗、马来西亚、墨西哥、南非、西班牙和泰国。共有 305 名 IPC 专业人员完成了该计划。参与者包括护士（n = 196；64.2%）、医生（n = 53；17.3%）和其他卫生专业人员（n = 56；18.3%）。总共有来自 20 多个国家的参与者接受了培训。在所有国家/地区都观察到 TTT 培训前后阶段之间的知识显着提高 (p < 0.05)。普埃布拉（墨西哥）的改善幅度最大（22.3%；p < 0.001），其次是马来西亚（21.2%；p < 0.001）、哈利斯科州（墨西哥；20.2%；p < 0.001）、泰国（18.8%；p < 0.001） 、南非（18.3%；p < 0.001）、伊朗（17.5%；p < 0.001）和西班牙（9.7%；p = 0.047）。西班牙的总体考试成绩最高，而泰国的考试前后分数最低。报告的积极方面包括：独特的学习环境、分享经验、安全环境中的动手实践以及 IPC 专业人员之间的网络。通过在墨西哥（哈利斯科州和普埃布拉州）和西班牙的三个原始 TTT 课程地点进行的后续评估来评估可持续性：在第一次 TTT 后 5 个月、1 年和 2 年评估时，在最后一个后续阶段持续改进当然，分别。结论 手卫生模型中的 TTT 被证明在增强参与者的知识、分享经验和网络方面是有效的。IPC 专业人员可以在全球范围内使用这种参考培训方法来进一步向其他卫生保健工作者传播知识。结论 手卫生模型中的 TTT 被证明在增强参与者的知识、分享经验和网络方面是有效的。IPC 专业人员可以在全球范围内使用这种参考培训方法来进一步向其他卫生保健工作者传播知识。结论 手卫生模型中的 TTT 被证明在增强参与者的知识、分享经验和网络方面是有效的。IPC 专业人员可以在全球范围内使用这种参考培训方法来进一步向其他卫生保健工作者传播知识。