All Hands-on Deck: Use of a HCW Survey to Identify and Address Barriers to Hand Hygiene

Abstract

BackgroundHand hygiene (HH) is considered the most effective method for preventing healthcare-associated infections (HAIs); however, healthcare worker (HCW) compliance rates remain low nationwide. Some hospitals did report an initial increase in HH compliance during the COVID-19 pandemic however these increases were difficult to sustain. To develop targeted interventions to improve HH rates in a post-COVID-19 world, a three-hospital network developed a HCW survey assessing current practices and perceived barriers to HH compliance.MethodsA 14-item anonymous survey composed of Likert, Yes/No and open-ended questions was developed by an Infection Prevention and Quality team from across the network. Items assessed included clarity of HH education received, perceived HH effectiveness, willingness to provide and/or receive real-time feedback, assessment of potential perceived barriers and evaluation of effectiveness of potential targeted interventions. The survey was developed in Microsoft Forms and distributed via email in July 2021. Staff were given 2-weeks to complete the survey. Data analysis was completed in Microsoft Excel.Results1,001 HCWs completed the survey. 89% of respondents indicated that HH instructions received in the past year were extremely clear. 92% indicated that they perceived HH as very effective at preventing patients and self from acquiring an HAI. 93% indicated they would be receptive to someone asking them to perform HH if not seen not doing so, however only 45% indicated they always remind colleagues to perform HH. 57% identified availability of alcohol-based hand rub (ABHR) to be a significant barrier to performing HH. 79% ranked supplementing the existing secret shopper HH auditing program with real time feedback and coaching as an effective method to improve HH rates.ConclusionsSurvey results suggest that interventions aimed at improving the availability of ABHR, encouraging peer-to-peer reminders, and supplementing existing auditing processes with real time feedback and coaching may have greater impact on HH compliance than education.