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Peer-reviewedCC BY-NCInfection & chemotherapy

The Impact of a Hand Hygiene Education Program in Long-Term Care Facilities in Korea.

  • Dong Hoon Shin1
  • Rina Lee2
  • Hanju Kim2
  • Sohee Oh3
  • Hyemin Jung2,4,5,6
  • Won Mo Jang2,4,7
  • Kyoung Jun Song8
8 affiliations
  1. 1Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  2. 2Integrated Care Medical Team, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  3. 3Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  4. 4Department of Public Health and Community Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  5. 5Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
  6. 6Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
  7. 7Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. [email protected].
  8. 8Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
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Abstract

Background

Korea's rapid population aging has increased demand for long-term care facilities (LTCFs). Because LTCFs are vulnerable to infectious disease outbreaks, consistent hand hygiene (HH) practices among caregivers are essential. We evaluated an LTCF-tailored HH education program with measurement of caregiver compliance.Materials and methods

HH compliance rate (HHCR) was defined as the proportion of performed HH actions among the observed WHO five moments. In 2025, 17 LTCFs participated; 13 received HH education. Nine LTCFs also participated in 2024 (three received education in 2024, all nine in 2025). Facility-level effects of 2025 education were assessed using generalized linear mixed-effects models, and caregiver-level HH monitoring was analysed separately.Results

Education was associated with a greater improvement in HHCR from the first to second half monitoring periods in 2025 (interaction adjusted odds ratio, 8.83; 95% confidence interval [CI], 2.25-34.61; P=0.004). In the two-year enrolled facilities (n=9), 2025 HHCR differed by 2024 education status and monitoring periods (three-way interaction, P=0.008). Within 2024, facilities receiving education in 2024 showed greater HHCR improvement (odds ratio, 58.72; 95% CI, 5.42-635.87; P=0.002). In caregiver-level analyses for second half of 2025, HHCR was higher among educated caregivers than among non-educated (median, 80.0% vs. 12.0%; P=0.002). The weakest HH moment was before touching; education was associated with higher compliance before touching, before a clean procedure, and after body fluid exposure risk.Conclusion

In the multi-district study of 17 LTCFs, an in-person HH education program was associated with improved caregiver compliance. These findings support expanding and sustaining HH education across Korean LTCFs.

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Cite

BibTeXRIS
BibTeX
@article{shin2026impact,
  title = {{The Impact of a Hand Hygiene Education Program in Long-Term Care Facilities in Korea.}},
  author = {Dong Hoon Shin and Rina Lee and Hanju Kim and Sohee Oh and Hyemin Jung and Won Mo Jang and Kyoung Jun Song},
  journal = {Infection \& chemotherapy},
  year = {2026},
  month = sep,
  doi = {10.3947/ic.2026.0025},
  url = {https://europepmc.org/article/MED/42847631},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - The Impact of a Hand Hygiene Education Program in Long-Term Care Facilities in Korea.
AU  - Dong Hoon Shin
AU  - Rina Lee
AU  - Hanju Kim
AU  - Sohee Oh
AU  - Hyemin Jung
AU  - Won Mo Jang
AU  - Kyoung Jun Song
PY  - 2026
DA  - 2026/09/01
JO  - Infection & chemotherapy
DO  - 10.3947/ic.2026.0025
UR  - https://europepmc.org/article/MED/42847631
AB  - Background  Korea's rapid population aging has increased demand for long-term care facilities (LTCFs). Because LTCFs are vulnerable to infectious disease outbreaks, consistent hand hygiene (HH) practices among caregivers are essential. We evaluated an LTCF-tailored HH education program with measurement of caregiver compliance.Materials and methods  HH compliance rate (HHCR) was defined as the proportion of performed HH actions among the observed WHO five moments. In 2025, 17 LTCFs participated; 13 received HH education. Nine LTCFs also participated in 2024 (three received education in 2024, all nine in 2025). Facility-level effects of 2025 education were assessed using generalized linear mixed-effects models, and caregiver-level HH monitoring was analysed separately.Results  Education was associated with a greater improvement in HHCR from the first to second half monitoring periods in 2025 (interaction adjusted odds ratio, 8.83; 95% confidence interval [CI], 2.25-34.61; P=0.004). In the two-year enrolled facilities (n=9), 2025 HHCR differed by 2024 education status and monitoring periods (three-way interaction, P=0.008). Within 2024, facilities receiving education in 2024 showed greater HHCR improvement (odds ratio, 58.72; 95% CI, 5.42-635.87; P=0.002). In caregiver-level analyses for second half of 2025, HHCR was higher among educated caregivers than among non-educated (median, 80.0% vs. 12.0%; P=0.002). The weakest HH moment was before touching; education was associated with higher compliance before touching, before a clean procedure, and after body fluid exposure risk.Conclusion  In the multi-district study of 17 LTCFs, an in-person HH education program was associated with improved caregiver compliance. These findings support expanding and sustaining HH education across Korean LTCFs.
SN  - 2093-2340
SN  - 2092-6448
ER  -