This multimodal intervention which was an observationalstudy performed from 1999 to 2002. This study monitored if adherence to handhygiene and glove use would reduce the risk of AMR in health facilities. Thiswas done in 4 intervention hospitals (660-bed acute and long-term carehospital, a 120-bed community hospital, a 600-bed public teaching hospital anda 700-bed university hospital)17. The goal of the study was toincrease the availability of alcohol-based hand rubs, education program andcampaign/posters17. At the control hospital only availability of thealcohol-basedhand rubs was increased. The intervention used in this study is the HealthBehavior Model (HBM).
“The HBM suggests that a person’s belief in a personalthreat of an illness, with the effectiveness of the recommended health behaviorpredicts the probability the person will adopt to that behavior”19. The educational intervention wasguided by a survey which were distributed during the infection control sessionswhich asked participants about their understanding of transmissible pathogensand opinion about hand hygiene (ex: skin irritants)17. The posterincluded high profile hospital administrative and clinical staff encouraginghand hygiene by using alcohol-based hand rubs. This study observed 6,948 handhygiene instances during all shifts.
During the study frequency of hand hygieneand glove use had increased in the intervention hospitals but not at thecontrol hospital17. The frequencies of hand hygiene and glove usewere as follows at the intervention hospitals (74%, 80%, and 72%) and 59% atthe control hospital17. Providers and workers were more likely touse the alcohol-based hand rubs than the old-fashioned soap and water orgloves. This study concluded a significant decrease incidence of antimicrobialresistant bacteria in the intervention hospitals.
When individuals are aware ofbeing observed, they are more likely to practice those behaviors which may be alimitation of this study and observations were selected from only the study hospitals.Some of the strengths of this study was that there was a control hospital inwhich educational programs or campaigning was not provided and this study wasdone over a period of 3 years and included roughly 7,000 observations.