Tjallie van der Kooi

Table 2: Univariable and multivariable estimates of the effect on the change of hand hygiene compliance Univariable estimate Multivariable estimate pp CI95% p‐value PP CI95% p‐value Professionals Nurse/student nurse Ref. Ref. Auxiliaries 0.8 (‐4.1–5.7) 0.74 0.4 (‐3.5–4.4) 0.84 Medical doctors / students ‐2.4 (‐7.3–2.5) 0.34 ‐5.7 (‐9.7– ‐1.7) 0.005 Other healthcare professionals 6.3 (‐2.6–15.2) 0.17 4.1 (‐3.5–11.7) 0.29 Type of ICU Medical/surgical Ref. Ref. Cardiosurgery ‐7.8 (‐25.7–10.1) 0.39 Vascular surgery ‐6.3 (‐23.1–10.6) 0.47 Activity index 1,2 Per one extra opportunity/h ‐0.6 (‐0.8– ‐0.4) <0.0001 ‐0.6 (‐0.8– ‐0.4) <0.0001 Baseline compliance 2 Per PP higher compliance ‐0.6 (‐0.7– ‐0.5) <0.0001 ‐0.6 (‐0.7– ‐0.5) <0.0001 Nurse‐to‐patient ratio 2 Per PP increase 0.2 (‐0.1–0.5) 0.25 0.5 (0.07–0.8) 0.02 1Activity index of the sessions during the intervention period. 2Differences of mean (centered) CI95%, 95% confidence interval; PP, percentage point from psychology and implementation science may be helpful to tailor improvement strategies to prospectively identified determinants of HH [35‐37]. Data on the level of HH compliance needed to prevent cross‐transmission are limited to modelling studies. Three reports identified a “threshold” of mean HH compliance above which pathogen transmission and infections would start to decline to be 48%, 66% and 87%, respectively, always assuming that each HH action results in a total eradication of pathogen transmission[38‐40]. Models taking into account less than 100% efficacy, conclude that no level of HH can be identified as “good enough” to prevent transmission[41‐43]. Most importantly, models have demonstrated that the

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