{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:24:39Z","timestamp":1783225479707,"version":"3.54.6"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T00:00:00Z","timestamp":1462838400000},"content-version":"unspecified","delay-in-days":648,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec id=\"S0899823X0019261X_abs1\"><jats:title>Background<\/jats:title><jats:p>Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X0019261X_abs2\"><jats:title>Methods<\/jats:title><jats:p>We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated <jats:italic>Staphylococcus aureus<\/jats:italic> bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X0019261X_abs3\"><jats:title>Results<\/jats:title><jats:p>The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X0019261X_abs4\"><jats:title>Conclusions<\/jats:title><jats:p>The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative\u2019s introduction or because infection rates were already low and could not be further reduced.<\/jats:p><\/jats:sec>","DOI":"10.1086\/677160","type":"journal-article","created":{"date-parts":[[2014,6,20]],"date-time":"2014-06-20T18:39:39Z","timestamp":1403289579000},"page":"1029-1036","source":"Crossref","is-referenced-by-count":16,"title":["Changes in Healthcare-Associated <i>Staphylococcus aureus<\/i> Bloodstream Infections after the Introduction of a National Hand Hygiene Initiative"],"prefix":"10.1017","volume":"35","author":[{"given":"Adrian G.","family":"Barnett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Page","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Brain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Rashleigh-Rolls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Halton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerina","family":"Jimmieson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Paterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Graves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,5,10]]},"reference":[{"key":"S0899823X0019261X_ref177","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2006.05.007"},{"key":"S0899823X0019261X_ref172","volume-title":"WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care","year":"2009"},{"key":"S0899823X0019261X_ref183","doi-asserted-by":"publisher","DOI":"10.1111\/j.2041-210X.2009.00009.x"},{"key":"S0899823X0019261X_ref176","doi-asserted-by":"publisher","DOI":"10.1080\/00207540600622449"},{"key":"S0899823X0019261X_ref170","article-title":"Interventions to improve hand hygiene compliance in patient care","volume":"2010","author":"Gould","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X0019261X_ref166","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-6701(13)60004-3"},{"key":"S0899823X0019261X_ref162","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.05.001"},{"key":"S0899823X0019261X_ref174","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1086\/521255","article-title":"Statistical analysis and application of quasi experiments to antimicrobial resistance intervention studies","volume":"45","author":"Shardell","year":"2007","journal-title":"Clin Infect Dis"},{"key":"S0899823X0019261X_ref185","doi-asserted-by":"crossref","first-page":"633","DOI":"10.5694\/j.1326-5377.2008.tb01820.x","article-title":"Significant reductions in methicillin-resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture-change program and subsequent successful statewide roll-out","volume":"188","author":"Grayson","year":"2008","journal-title":"Med J Aust"},{"key":"S0899823X0019261X_ref163","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-6701(01)90012-X"},{"key":"S0899823X0019261X_ref168","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70163-4"},{"key":"S0899823X0019261X_ref181","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1203333109"},{"key":"S0899823X0019261X_ref184","doi-asserted-by":"crossref","first-page":"509","DOI":"10.5694\/j.1326-5377.2005.tb07151.x","article-title":"Efficacy of an alcohol\/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection","volume":"183","author":"Johnson","year":"2005","journal-title":"Med J Aust"},{"key":"S0899823X0019261X_ref169","doi-asserted-by":"publisher","DOI":"10.1086\/670637"},{"key":"S0899823X0019261X_ref164","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.01.031"},{"key":"S0899823X0019261X_ref173","unstructured":"Australian Commission on Safety and Quality in Health Care (ACSQHC). Data set specification\u2013surveillance of healthcare associated infections: Staphylococcus aureus bacteraemia and Clostridium difficile infection (version 4.0). Sydney, Australia: ACSQHC, 2012. http:\/\/www.safetyandquality.gov.au\/publications\/data-set-specification-surveillance-of-healthcare-associated-infections-staphylococcus-aureus-bacteraemia-and-clostridium-difficile-infection-version-4-0\/. 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