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Squires, J.E., Suh, K.N., Linklater, S., Bruce, N., Gartke, K., Graham, I.D., Karovitch, A., Read, J., Virginia Roth, V., Stockton, K., Tibbo, E., Woodhall, K., Worthington, J. and Grimshaw, J.M. (2013) Improving Physician Hand Hygiene Compliance Using Behavioural Theories: A Study Protocol. Implementation Science, 8, 16.
http://dx.doi.org/10.1186/1748-5908-8-16

has been cited by the following article:

• TITLE: A Case Study and the Lessons Learned from In-House Alcohol Based Hand Sanitizer Production in a District Hospital in Rwanda

  AUTHORS: April Budd, Stephanie Lukas, Unarose Hogan, Kamugisha Priscille, Kanamugire Fann, Pauline Hill, Ndikumana Edouard, Jean Bosco Byukusenge, Ntigurirwa Placide, Mutayomba Aimable, Rex Wong

  KEYWORDS: In-House Production of Hand Sanitizer, Resource-Limited Setting, Hand Hygiene, Hospital Acquired Infection, Quality Improvement

  JOURNAL NAME: Journal of Service Science and Management, Vol.9 No.2, April 13, 2016

  ABSTRACT: Health-care-associated infections (HCAIs) are a major global safety concern for patients, health- care professionals and public health particularly in developing countries where access to hand washing facilities is limited due to infrastructure. Alcohol-based hand sanitizer offers a viable alternative where water sources are unreliable or insufficient. However, in resource-limited settings, the introduction of alcohol-based hand sanitizer has been slow due to economic, manufacturing and procurement challenges compounded by the lack of evidence as to its acceptability in varying organizational cultures. This case study describes the process of producing, educating, distributing, scaling up and monitoring the impact of a quality improvement project to locally produce alcohol based hand sanitizer using the formula provided by the World Health Organization in a district hospital in Rwanda. During a 10-month implementation, hand sanitizer was made available to all departments of the hospital and all hospital staff received training on the proper use and ordering of the product. The overall hand hygiene compliance using any method significantly increased from 59% pre intervention to 67% post intervention (P