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The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial

Author

Listed:
  • Christopher Fuller
  • Susan Michie
  • Joanne Savage
  • John McAteer
  • Sarah Besser
  • Andre Charlett
  • Andrew Hayward
  • Barry D Cookson
  • Ben S Cooper
  • Georgia Duckworth
  • Annette Jeanes
  • Jenny Roberts
  • Louise Teare
  • Sheldon Stone

Abstract

Introduction: Achieving a sustained improvement in hand-hygiene compliance is the WHO’s first global patient safety challenge. There is no RCT evidence showing how to do this. Systematic reviews suggest feedback is most effective and call for long term well designed RCTs, applying behavioural theory to intervention design to optimise effectiveness. Methods: Three year stepped wedge cluster RCT of a feedback intervention testing hypothesis that the intervention was more effective than routine practice in 16 English/Welsh Hospitals (16 Intensive Therapy Units [ITU]; 44 Acute Care of the Elderly [ACE] wards) routinely implementing a national cleanyourhands campaign). Intervention-based on Goal & Control theories. Repeating 4 week cycle (20 mins/week) of observation, feedback and personalised action planning, recorded on forms. Computer-generated stepwise entry of all hospitals to intervention. Hospitals aware only of own allocation. Primary outcome: direct blinded hand hygiene compliance (%). Results: All 16 trusts (60 wards) randomised, 33 wards implemented intervention (11 ITU, 22 ACE). Mixed effects regression analysis (all wards) accounting for confounders, temporal trends, ward type and fidelity to intervention (forms/month used). Intention to Treat Analysis: Estimated odds ratio (OR) for hand hygiene compliance rose post randomisation (1.44; 95% CI 1.18, 1.76;p

Suggested Citation

  • Christopher Fuller & Susan Michie & Joanne Savage & John McAteer & Sarah Besser & Andre Charlett & Andrew Hayward & Barry D Cookson & Ben S Cooper & Georgia Duckworth & Annette Jeanes & Jenny Roberts , 2012. "The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-10, October.
    • Handle: RePEc:plo:pone00:0041617
    DOI: 10.1371/journal.pone.0041617
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    References listed on IDEAS

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    1. Gardner, Benjamin & Whittington, Craig & McAteer, John & Eccles, Martin P. & Michie, Susan, 2010. "Using theory to synthesise evidence from behaviour change interventions: The example of audit and feedback," Social Science & Medicine, Elsevier, vol. 70(10), pages 1618-1625, May.
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    1. Potthoff, Sebastian & Kwasnicka, Dominika & Avery, Leah & Finch, Tracy & Gardner, Benjamin & Hankonen, Nelli & Johnston, Derek & Johnston, Marie & Kok, Gerjo & Lally, Phillippa & Maniatopoulos, Gregor, 2022. "Changing healthcare professionals' non-reflective processes to improve the quality of care," Social Science & Medicine, Elsevier, vol. 298(C).

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