Train-the-Trainers in hand hygiene: A standardized approach to guide education in infection prevention and control

Tartari, E. and Fankhauser, C. and Masson-Roy, S. and Márquez-Villarreal, H. and Fernández Moreno, I. and Rodriguez Navas, M. L. and Sarabia, O. and Bellisimo-Rodrigues, F. and Hernández-De Mezerville, M. and Lee, Y. F. and Aelami, M. H. and Mehtar, S. and Agostinho, A. and Camilleri, L. and Allegranzi, B. and Pires, D. and Pittet, D. (2019) Train-the-Trainers in hand hygiene: A standardized approach to guide education in infection prevention and control. Antimicrobial Resistance and Infection Control, 8 (1).

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Background: Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a "Train-the-Trainers" (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods: We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results: Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2), physicians (n = 53; 17.3) and other health professionals (n = 56; 18.3). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3; p < 0.001), followed by Malaysia (21.2; p < 0.001), Jalisco (Mexico; 20.2; p < 0.001), Thailand (18.8; p < 0.001), South Africa (18.3; p < 0.001), Iran (17.5; p < 0.001) and Spain (9.7; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions: The TTT in hand hygiene model proved to be effective in enhancing participant's knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers. © 2019 The Author(s).

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Pittet, D.; Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, Switzerland; email:
Uncontrolled Keywords: Behavioural change Education Hand hygiene Healthcare-associated infection Implementation Improvement Infection prevention and control Multimodal strategy Simulation training Train-the-Trainers World Health Organization Article attitude to health behavior change controlled study country economic status follow up hand washing health care personnel health program healthcare associated infection human infection control infection prevention Iran learning environment Malaysia medical education Mexico practice guideline priority journal program sustainability scoring system South Africa Spain Thailand work experience
Subjects: W General medicine- Health professions
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 27 Jun 2020 06:00
Last Modified: 27 Jun 2020 06:00

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