A behaviour change package to prevent hand dermatitis in nurse working in the National Health Service: results of a cluster randomised controlled trial

Madan, I.; Parsons, V.; Ntani, G.; Coggon, D.; Wright, A.; English, J.; McCrone, P.; Smedley, J.; Rushton, L.; Murphy, C.; Cookson, B.; Williams, H C

Abstract

Background
Occupational hand dermatitis poses a serious risk for nurses.

Objectives
To evaluate the clinical and cost?effectiveness of a complex intervention in reducing the prevalence of hand dermatitis in nurses

Trial design
Cluster randomised controlled trial at 35 hospital trusts/health boards/universities in the United Kingdom.

Methods
Participants were (i) first year student nurses with a history of atopic conditions (ii) intensive care unit (ICU) nurses. Participants at intervention sites received access to a behaviour change programme plus moisturising creams. Participants at control sites received usual care. The primary outcome was the change of prevalent dermatitis at follow?up (adjusted for baseline dermatitis) in the intervention versus the control group. Randomisation was blinded to everyone bar the trials unit to ensure allocation concealment.

Results
14 sites were allocated to the intervention arm and 21 to the control arm. 2,040 (69.5%) nurses consented to participate and were included in the intention?to?treat analysis. The baseline questionnaire was completed by 1,727 (87.4%) participants. 789 (91.6%) ICU nurses and 938 (84.0%) student nurses returned completed questionnaires. Of these, 994 (57.6%) had photographs taken at baseline and follow?up (12?15 months). When adjusted for baseline prevalence of dermatitis and follow?up interval the odds ratio (95% confidence interval) for hand dermatitis at follow?up in the intervention group relative to the controls were 0.72 (0.33?1.55) and 0.62 (0.35?1.10) for student and ICU nurses respectively.

Harm
None reported

Conclusion
There was insufficient evidence to conclude whether our intervention was effective in reducing hand dermatitis in our populations.

• Journal Article Type: Article
• Acceptance Date: Jan 6, 2020
• Online Publication Date: Jan 27, 2020
• Publication Date: 2020-09
• Deposit Date: Jan 13, 2020
• Publicly Available Date: Jan 28, 2021
• Journal: British Journal of Dermatology
• Print ISSN: 0007-0963
• Electronic ISSN: 1365-2133
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 183
• Issue: 3
• Pages: 462-470
• DOI: https://doi.org/10.1111/bjd.18862
• Keywords: Dermatology
• Public URL: https://nottingham-repository.worktribe.com/output/3719275
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.18862?af=R
• Additional Information: Published: 2020-01-27