An infection control and educational program with no cost

Abstract

ISSUE: Hand hygiene is an essential way for infection control and prevention and is required of all medical staff. However, it is regrettable that compliance rates for hand hygiene are low, and infection control professionals in healthcare facilities struggle to raise the rates. To date, the methods for hand hygiene programs were limited to studies of antisepsis, analyses using questionnaires among medical staff, etc. We developed an innovative method to improve attention to hand hygiene in the medical staff and also to educate medical students, without extra expense. PROJECT: This program was conducted in February 2004, as a part of the infection control and prevention training for students, at the fourth grade of department of medicine, at the university. One hundred and one students were dispatched to all of the wards of the hospital (consent from the wards' heads had been obtained in advance). Students were requested to observe whether or not the staff washed their hands with alcohol-based products when they went into and out of the patient rooms, for 2 consecutive days. The hand hygiene check was carried out unnoticed on the first day. At the last moment on the first day, we notified all the staff in the hospital that hand hygiene check was in operation. The hand hygiene check on the second day was carried out openly. The reports submitted by the students were sent to each ward. RESULTS: A number of opinions were obtained from both the staff and students. Some staff members claimed that the study was operated without notice, while others welcomed the study even when it was performed without notification. After this study, hand hygiene execution rate was improved, particularly in nurses. Some students stated, “We realized again the importance of hand hygiene,” and “We are sure to carry out handwashing when we are in charge of the ward training.” Actually, most students—who will be working in the wards in a few years—became more conscious of the need for handwashing in the wards. LESSONS LEARNED: The aim of this program was not to estimate the exact hand hygiene rate but to improve the attention of the staff to hand hygiene. This method was effective in our university hospital in that 1) it needed no budget, and 2) the attention to hand hygiene was much improved among both the medical staff members, who were observed by students, and among the students, who observed the staff.