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The ICPIC taskforce acknowledges that several factors affect the antimicrobial efficacy of ABHR , including the volume of ABHR applied to the hands , dry time , ABHR formulation , and laboratory method ( s ) used to evaluate antimicrobial efficacy , compounded by multiple other factors likely to affect ABHR effectiveness in reducing HAIs and transmission of healthcare pathogens . However , no prospective controlled trial has compared the effectiveness of different ABHR formats in reducing HAIs .
Tartari , et al . ( 2024 ) report that a review of 41 studies revealed that all ABHR formats have been successful in improving hand hygiene compliance rates when combined with multi-modal improvement strategies , with varying abilities to yield significant reductions in HAIs or pathogen transmission ( manuscript in preparation ). However , the authors point out , differences in the frequency of significant HAI reduction achieved by liquid , gel and foam formats were not statistically significant .
The absence of sufficient in-vivo laboratory studies to evaluate the antimicrobial efficacy of ABHRs is a lability in understanding and promoting hand hygiene science . As the taskforce emphasizes , “ Clinical studies including healthcare providers involved in direct patient care are essential to evaluate the impact of skin tolerability , acceptability , application frequency and compliance on HAIs . The lack of randomized controlled trials to determine the effectiveness of various ABHR formats in reducing HAIs and pathogen transmission .”
Related to automated hand hygiene monitoring systems ( AHHMSs ), the taskforce identified as gaps the accuracy of automated hand hygiene monitoring systems in multiple healthcare settings as well as these systems ’ capability of accurately assessing the quality of hand hygiene practices . They also call for methodological protocols for research evaluating the accuracy of automated systems ; guidance on the definition of true and false hand hygiene events and the statistical measures appropriate for evaluating accuracy ; as well as development and validation of a system to evaluate the colonization risk in hospitalized patients considering all hand hygiene actions . They also say a model to predict the colonization risk associated with patient interactions would be helpful .
Of note , the ICPIC taskforce addressed the summary of the research agenda for
hand hygiene in healthcare for 2023 – 2030 as released by WHO .
As Tartari , et al . ( 2024 ) explain , “ The goal of the agenda is to accelerate knowledge generation regarding the best interventions to improve hand hygiene practices , which will improve the quality of care and patient outcomes and reduce the risk of HAIs and AMR . The research agenda provides guidance to researchers , policymakers , and donors by focusing on six core hand hygiene domains : system change , training and education , evaluation and feedback , reminders and communication , institutional safety climate , and the impact of hand hygiene on HAIs / AMR . The highest research priorities include identifying approaches or interventions needed to facilitate sustained system change ; assessing the efficacy of hand hygiene agents in removing a range of organisms ; evaluating the impact of different hand hygiene training and educational strategies ; assessing the use of data feedback on barriers to and predictors of hand hygiene compliance ; and determining the association between an increase in hand hygiene compliance and a reduction in transmission , colonization , and / or infection by microorganisms of interest .”
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