Abstract
BackgroundDuring the Severe Acute Respiratory Syndrome (SARS) outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO) "Clean Care is Safer Care" program.FindingsA multi-prong approach was used in designing the hand hygiene program. This included system change; training and education; evaluation and feedback; reminders in the workplace; and institutional safety climate. Hand hygiene compliance rate improved from 20% (in January 2007) to 61% (2010). Improvement was also seen annually in the compliance to each of the 5 moments as well as in all staff categories. Healthcare-associated MRSA infections were reduced from 0.6 (2007) to 0.3 (2010) per 1000 patient-days.ConclusionsLeadership's support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. The hospital was recognised as a Global Hand Hygiene Expert Centre in January 2011. The WHO multi-prong interventions work in improving compliance and reducing healthcare associated infections.
Highlights
During the Severe Acute Respiratory Syndrome (SARS) outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear
The World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy comprising a Guide to Implementation and a range of tools constructed to facilitate implementation of each component was used in a 1600-bedded acute tertiary care general hospital in Singapore [1]
Following the closure of the SARS outbreak globally, we noted that the hand hygiene compliance decreased to
Summary
Leadership’s support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. During the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, a high compliance of close to 90% in healthcare workers to hand hygiene was achieved. During SARS, alcohol hand rub bottles were installed at the foot of every patient bed and all lift lobbies in an attempt to enable easy access by healthcare workers to hand hygiene products. From July 2009, 4% chlorhexidine handwash agent bottles were removed from the clinical areas except for the Operating Theatres, Endoscopy Unit and treatment rooms This was done to reduce the incidence of dryness or skin irritation resulting from concomitant use of both alcohol and chlorhexidine [1]. WHO training DVDs were used to illustrate clinical scenarios of hand hygiene opportunities to all healthcare workers These were in French, they provided clear teaching on the 5 moments to the staffs. These were uploaded on the hospital intranet for easy access by the staffs
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