Challenges of implementing a haemodialysis specific hand hygiene program across multiple countries

Abstract

Introduction: Haemodialysis patients are vulnerable to acquiring healthcare associated infections. This is due to their chronic disease, frequent exposure to healthcare facilities and receiving invasive dialysis treatments three times per week. Compliance with hand hygiene is very important in minimising healthcare associated infections. In 2012 a hand hygiene program was implemented in the Australian dialysis clinics. In 2015 we began implementing haemodialysis specific hand hygiene programs into our dialysis clinics in other Asia Pacific countries. The challenges we faced were creating a hand hygiene auditor training program specifically for haemodialysis which also addressed cultural and linguistic differences. Methods: Australia dialysis clinics had an effective Infection Prevention and Control (IPC) Link Nurse program which included hand hygiene auditing. This program was replicated in the Asia Pacific dialysis clinics. We developed haemodialysis specific hand hygiene auditor training resources which accommodated linguistic differences. Results: In 2012 two Australian dialysis clinics had trained hand hygiene auditors, but audits were not submitted to the National Hand Hygiene Initiative (NHHI). By December 2015 all 18 Australian dialysis clinics had qualified hand hygiene auditors and all clinics submitted audits to the NHHI. In Asia Pacific, in 2015 there were no trained IPC Link Nurses. By June 2016 there were 32 trained IPC Link Nurses in 29 clinics across four countries. The hand hygiene program improved awareness and compliance with hand hygiene actions. Additional benefits were improvements in general infection prevention and control processes in our haemodialysis clinics, which had IPC Link Nurses, across Asia Pacific.