Effectiveness of motivational interviewing for improvement of hand hygiene compliance and reduction of hospital acquired infection in intensive care unit.

BACKGROUND

Hospital-acquired infections (HAIs) impose a global burden, with hand hygiene (HH) a key preventive measure. Sustaining HH compliance requires behavioral change. Motivational interviewing (MI), promotes self-reflection and shows promise. This study evaluated MI's effectiveness on HH compliance among health care workers and its impact on HAI rates.

METHODS

This prospective interventional study was conducted from June 2018 to February 2019 in a tertiary hospital MICU involving 29 doctors (8 consultants, 21 residents). Three-month pre-intervention phase recorded baseline HH compliance and HAI rates [central line-associated bloodstream infection (CLABSI), Ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI)]. Intervention included educational, MI sessions, and promotional videos. Post-intervention, HH compliance, readiness to change, and HAI rates were reassessed. Compliance was analysed using multilevel mixed-effects linear regression, and product use was compared using Wilcoxon rank-sum test. P-value <.05 was considered statistically significant.

RESULTS

Among 650 observed opportunities, HH compliance improved significantly post-intervention (~41% to ~65%-70%; P < .001). Residents improved more than consultants. Alcohol based handrubs and soap use showed no significant change. VAP and CAUTI decreased (P = .0495), while CLABSI remained unchanged.

CONCLUSIONS

Multimodal strategy combining education and MI improved HH compliance among doctors. Its impact on HAIs remains uncertain, warranting investigation.