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dc.contributor.authorFuller, Chris
dc.contributor.authorMichie, Susan
dc.contributor.authorSavage, Joanne
dc.contributor.authorMcAteer, John
dc.contributor.authorBesser, Sarah Jane
dc.contributor.authorCharlet, Andrew
dc.contributor.authorHayward, Andrew
dc.contributor.authorCookson, Barry
dc.contributor.authorCooper, Ben
dc.contributor.authorDuckworth, Georgia
dc.contributor.authorJeans, Anette
dc.contributor.authorRoberts, Jenny
dc.contributor.authorTeare, Louise
dc.contributor.authorStone, Sheldon
dc.date.accessioned2017-03-09T17:39:23Z
dc.date.available2017-03-09T17:39:23Z
dc.date.issued2012-10-23
dc.identifier.citationFuller , C , Michie , S , Savage , J , McAteer , J , Besser , S J , Charlet , A , Hayward , A , Cookson , B , Cooper , B , Duckworth , G , Jeans , A , Roberts , J , Teare , L & Stone , S 2012 , ' The Feedback Intervention Trial (FIT) - improving hand-hygiene compliance in UK healthcare workers : a stepped wedge cluster randomised controlled trial ' , PLoS ONE , vol. 7 , no. 10 , e41617 . https://doi.org/10.1371/journal.pone.0041617
dc.identifier.issn1932-6203
dc.identifier.otherPURE: 10489813
dc.identifier.otherPURE UUID: 2150ea5f-73ee-4774-a34c-58e7179fb5bc
dc.identifier.otherScopus: 84867862589
dc.identifier.otherORCID: /0000-0003-3252-9665/work/32383998
dc.identifier.urihttp://hdl.handle.net/2299/17689
dc.descriptionCopyright: © 2012 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Fuller, C., et al, 'The Feedback Intervention Trial (FIT) - Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial', PLoS ONE Vol. 7(10): e41617. The version of record is available at doi: 10.1371/journal.pone.0041617 Published by PLOS ONE
dc.description.abstractIntroduction:  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.MethodsThree 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 (%).ResultsAll 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 AnalysisEstimated odds ratio (OR) for hand hygiene compliance rose post randomisation (1.44; 95% CI 1.18, 1.76;p<0.001) in ITUs but not ACE wards, equivalent to 7–9% absolute increase in compliance.Per-Protocol Analysis for Implementing WardsOR for compliance rose for both ACE (1.67 [1.28–2.22]; p<0.001) & ITUs (2.09 [1.55–2.81];p<0.001) equating to absolute increases of 10–13% and 13–18% respectively. Fidelity to intervention closely related to compliance on ITUs (OR 1.12 [1.04, 1.20];p = 0.003 per completed form) but not ACE wards.ConclusionDespite difficulties in implementation, intention-to-treat, per-protocol and fidelity to intervention, analyses showed an intervention coupling feedback to personalised action planning produced moderate but significant sustained improvements in hand-hygiene compliance, in wards implementing a national hand-hygiene campaign. Further implementation studies are needed to maximise the intervention’s effect in different settings.Trial RegistrationControlled-Trials.com ISRCTN65246961en
dc.language.isoeng
dc.relation.ispartofPLoS ONE
dc.titleThe Feedback Intervention Trial (FIT) - improving hand-hygiene compliance in UK healthcare workers : a stepped wedge cluster randomised controlled trialen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Psychology and Sports Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.description.statusPeer reviewed
dc.identifier.urlhttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041617
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1371/journal.pone.0041617
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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