Hand Hygiene: Staff-Driven Approach Leads to Success

Abstract

ISSUE: Since Ignaz Semmelweis first demonstrated the effectiveness of hand hygiene in reducing instances of puerperal sepsis, hand hygiene has been the key concept in reducing the transmission of organisms. Despite the availability of hand sanitizers in the hallways and reminders by Infection Control personnel, compliance with hand hygiene at our institution was similar to trends of low hand hygiene compliance as reported nationally. PROJECT: In 2004, the Infection Control Department, in conjunction with Quality Management, initiated a hospital wide hand hygiene campaign, whose goal was to improve staff compliance with hand hygiene. One nursing unit volunteered to be the initial "kick-off" unit. Staff determined how to implement the initiative on their unit. They were empowered to intercede with any health care worker who missed a hand hygiene opportunity. Education via lectures and glow-in-the-dark handwashing demonstrations started the campaign. A hospital-wide slogan contest for the campaign was held with a prize awarded for the winning slogan. Physician Champions of Hand Hygiene promoted hand hygiene during rounds and physician presentations. Other initiatives to increase awareness hand hygiene included letters to Chairman, publishing in facility newsletter pictures of Administrators "caught in the act" performing hand hygiene, and rewards to employees observed performing hand hygiene. Data from anonymous observations were compiled weekly and results provided to the unit in a trending graph. RESULTS: As a result of staff-driven unit-based hand hygiene initiatives, observations of physicians, nurses and patient care associates demonstrated improvement in compliance with hand hygiene. Overall mean compliance went from a baseline of 34% in March 2004 to an improved rate of 80% that was sustained and was the impetus for expansion of the campaign to additional units in September 2005. The initial unit's recommendation to place hand sanitizers in each patient room was implemented. LESSONS LEARNED: Personal "buy-in" and unit self-determination, in addition to education and feedback of compliance data, are key in implementing a successful hand hygiene campaign. Hand hygiene education and reminders to staff continue to maintain increased compliance and guarantee success.