Impact of a training strategy on improving compliance of hand hygiene and gloving during the placement of a short peripheral venous catheter: the multicentre study CleanHand4
Authors: Farizon Mathilde , dos Santos Sandra , Richard Lucas , Petiteau Agnès , Valentin Anne-Sophie , van der Mee-Marquet Nathalie ,   on behalf of the CleanHand4 collaboration group, Alexandre Kimberley , Allaire Alexandra , Amandier Karine , Audrain Nathalie , Azzam Amina , Bastard Mehdi , Berrahal Mélika , Berrouane Yasmina , Betti Marie-Camille , Bianchi Claire , Blanié Mathilde , Borrelys Laetitia , Boschet Caroline , Bourdet Alexandre , Brisson Jihane , Brechat Anne , Buiguez Dominique , Caffort Sandra , Chatelet Céline , Chatin Catherine , Chevalier Karine , Choquet Armelle , Coire Amélie , Courcelle Karine , Cremoux Nathalie , Dangel Michèle , Debarre Cécile , Decruyenaere Lydia , Delavault Peggy , Diaw Frédérique , Dobras Marie , Domrault-Tanguy Carole , Drot Sylvie , Duchemin Audrey , Durand-Joly Isabelle , El Kallas Claude , Formery Christelle , Fournier Pierre , Franck Aline , Ghalloussi Blanche , Ghironi Nathalie , Godet Marie , Goudouneche Anne , Gregoire Jill , Guermazi Hedia , Idri Nadia , Jacques–Gustave Emmanuelle , Joron Sylvie , Joseph Laurence , Kayoulou-Bour Anne-Marie , Keswani Maha , Kmiecik Annick , Lafargue Marie , Laffon Magalie , Lafond Elodie , Le Falher Bruno , Le Gouil Cécile , Leconte Sophie , Malfondet Florence , Marty Sandrine , Mertel Nadine , Morange Virginie , Morette Floriane , Mouronval Jennifer , Moutarde Sylvie , Negrin Nadine , Ollivier Dominique , Perez Anne , Pommier Pauline , Pouponnot Kahina , Pouy Berlemont Isabelle , Raumel Samantha , Rossi Patricia , Roudaut Noella , Roux-Sibillon Bénédicte , Saez de Ibarra Dominique , Schrevens Muriel , Sidikou Ousseini , Tamburro Bertille , Theaude Catherine , Thevenot Sarah , Turpin Jessica , Valsaque Morgane , Veja Séverine , Wojciechowski Lucie , Zangoli Laure 
Published: October 2023

Abstract
Background
Patients who have short peripheral venous catheters (PVC) face an elevated risk of developing bloodstream infections. Preventing catheter-related infections relies on implementing multiple measures, including practicing proper hand hygiene (HH) during catheter placement.

Methods
We conducted a four-part study: (1) an evaluation of HH practices through direct observation of PVC placements, coupled with the study of the microbial flora of the HCWs fingers just before the placement; (2) the development of an educational tool based on the collected observational and microbiological data; (3) the training to the HCWs observed during the first part, using this tool; and (4) the subsequent observation of the trained HCWs to measure the impact of the training on practice improvement.

Results
Compliant HH was observed in 23.5% of the 647 HCWs observed during PVC placement before training. The microbiological study revealed fewer pathogens on the fingertips of the HCWs practicing compliant HH compared other HCWs (2.6 vs 11,7%; p = 0.003). The comparison of practices before and after training, assessed among 180 HCWs, showed an increase in the proportion of HCWs performing compliant HH (25.0 vs 63.2%; p < 0.001).

Conclusions
Training HCWs using our educational tool, which combines reminders of best practices and risk factors associated with PVC-related infections, engaging HCWs (presentation of practice evaluation), identifying professionals deviating from best practices (simulation videos), and objectively assessing fingertip contamination (microbiological study), significantly improved compliance with HH gestures and glove usage. We encourage infection control teams to utilize this tool to raise awareness among HCWs responsible for PVC placement about the risk of infection associated inadequate hand hygiene.