Improved Hand Hygiene Compliance through “I Save Lives with Clean Hands” Campaign

Abstract

ISSUE: Improvement of hand hygiene compliance was initiated at a multiservice VA healthcare facility soon after the CDC publication of the 2002 Guideline for Hand Hygiene in Healthcare Settings. Facility hand hygiene policy was revised to include all of the Category 1A, 1B, and 1C recommendations. Baseline hand hygiene compliance reflected an unacceptable rate of 57% (120/209). Compliance in intensive care units was lower at 33% (35/107). In 2004, Infection Control(IC) realized that more than policy change was required to improve compliance and developed a Hand Hygiene Program. Leadership supported the program adding a licensed professional nurse position to the IC staff to assist with hand hygiene observations and data collection. PROJECT: The program included (1) Mandatory computerized instruction in hand hygiene for all employees, (2) Unannounced observations of hand hygiene with performance feedback to staff, (3) Implementation of a highly visible promotional hand hygiene campaign “I Save Lives with Clean Hands” and (4) Modification of resources to meet needs of specialized areas. Leadership allocated $1000 for conducting the campaign. RESULTS: Although compliance in hand hygiene training was successful at 95%, practice at 61% (288/476) did not improve significantly even with performance feedback. (p > .05) After “I Save Lives with Clean Hands” campaign was conducted performance did improve to 94% (342/362). (p ≤ .003) Activities in the campaign included extensive education, reinforcing positive behavior, displaying visual aids throughout the facility, distributing large red logo buttons with white lettering “I SAVE LIVES WITH CLEAN HANDS”, and distributing hand hygiene supply bags containing pocket size gel, campaign paraphernalia, and handouts. All levels of healthcare workers from leadership to direct care providers actively participated in activities including wearing logo buttons. LESSONS LEARNED: Policy change and mandatory electronic education alone did not improve hand hygiene compliance to an acceptable level. Hand hygiene compliance was improved by (1) Committed leadership support (2) Appropriate allocation of resources (3) Facility actions that prioritize patient safety and (4) Active participation of all staff in the program. FY06 Hand Hygiene Program includes plans for an annual system-wide hand hygiene awareness campaign, continued distribution of hand hygiene supply bags to medical staff, and staff recognition of high performers.