TY - JOUR T1 - Effectiveness and sustainability of the WHO multimodal hand hygiene improvement strategy in the University Hospital Bouaké, Republic of Côte d'Ivoire in the context of the COVID-19 pandemic AU - Müller, Sophie Alice AU - N’Guessan, Micheline AU - Wood, Rebekah AU - Landsmann, Lena AU - Rocha, Carlos AU - Kouame, Bléoué Jean AU - Djadji, Dominique AU - Abrokwa, Seth Kof AU - Eckmanns, Tim AU - Arvand, Mardjan AU - Diané, Bamourou AU - Borchert, Matthias AB - Introduction: The most frequent adverse events in healthcare are healthcare-associated infections, whose burden is highest in resource-limited settings. In addition, low resource settings often lack Hand Hygiene (HH) knowledge and reliable supply to disinfectant, a necessity emphasized by the past West African Ebola Epidemic and the ongoing COVID-19 pandemic. PASQUALE aims to increase patient safety by introducing the WHO multimodal HH strategy in the University Hospital Bouaké, Côte d’Ivoire. Methods: Assessment of HH knowledge, perception and compliance was performed 12 months before, right after the intervention and at a ten months interval using questionnaires for knowledge and perception and direct observation for compliance. The intervention consisted of a HH training and the introduction of local production of alcohol-based hand-rub. In the absence of a control group, the effectiveness of the intervention was assessed by a before-and-after study. Results: Baseline knowledge score was 14/25, increased significantly to 17/25 (p < 0.001) upon first and decreased to 13/25 in second follow-up. Compliance showed a significant increase from 12.7% to 36.8% (p < 0.001) in first and remained at 36.4% in second follow-up. Alcohol-based hand-rub production and consumption almost doubled after first confirmed COVID-19 case in Côte d’Ivoire. Conclusion: The WHO HH improvement strategy is an effective and pandemic-adaptable method to increase long-term HH compliance. This study emphasizes that the implementation of the strategy to build a robust system is of utmost importance. KW - Hand hygiene KW - WHO multimodal strategy KW - First WHO Global Patient Safety Challenge KW - Clean care is safer care KW - Clean hands KW - Infection prevention and control KW - Healthcare-associated infections KW - Nosocomial infections KW - Alcohol-based hand rub KW - AHRB KW - Local disinfectant production KW - Bouaké KW - Côte d’Ivoire KW - University Hospital KW - 610 Medizin und Gesundheit PY - 2022 LA - eng PB - Robert Koch-Institut JO - Antimicrobial Resistance & Infection Control VL - 11 IS - 36 DO - 10.1186/s13756-021-01032-4 ER -