Innovative Surveillance and Execution of the World Health Organization's 5 Moments of Hand Hygiene in an Acute-care Hospital

Abstract

BACKGROUND Hand hygiene (HH) is critical to the prevention of serious infections in the healthcare setting. Caregivers have been found to have suboptimal HH practices. The World Health Organization (WHO) 5 Moments of HH program was implemented in an acute-care hospital in an effort to increase caregiver participation, renew interest, and raise visibility. METHODS Over a four month period in 2018, 128 participants were surveyed with an abbreviated WHO HH Perception Survey for Health-Care Workers in an acute-care and critical access hospital. Of the respondents, 67% were from nursing or ancillary nursing services. The abbreviated WHO HH Perception survey was utilized as a way to understand and improve caregiver perceptions and practices related to HH. A question highlighting HH improvement and the receipt of regular results regarding HH performance was targeted. RESULTS On the WHO HH Self-Assessment Framework (SAF) the acute-care hospital scored 280 (range of 0 – 500), intermediate, for HH facility level and obtained a satisfactory level of 12 for HH Leadership. On a scale of 1 – 7, 73% of overall participants rated “receiving regular feedback regarding HH performance” ≥ 5 on the WHO HH perceptions survey. Based on this feedback and the WHO HHSAF, the acute-care hospital implemented a multimodal approach to HH practices through a novel framework. CONCLUSIONS This targeted approach illuminated participant values regarding regular feedback on HH performance. In response, infection prevention implemented secret shopper HH cameras that rotate departments in conjunction with frequent rounding on units to provide immediate feedback on HH compliance and missed opportunities. Feedback was provided to floor nurses, nurse managers, and assistant nurse managers. Additionally, a dynamic traveling HH campaign was implemented to socialize the WHO 5 Moments. The campaign asked all staff to participate in HH activities and to renew their commitment to HH through unit specific posters and signatures. Hand hygiene (HH) is critical to the prevention of serious infections in the healthcare setting. Caregivers have been found to have suboptimal HH practices. The World Health Organization (WHO) 5 Moments of HH program was implemented in an acute-care hospital in an effort to increase caregiver participation, renew interest, and raise visibility. Over a four month period in 2018, 128 participants were surveyed with an abbreviated WHO HH Perception Survey for Health-Care Workers in an acute-care and critical access hospital. Of the respondents, 67% were from nursing or ancillary nursing services. The abbreviated WHO HH Perception survey was utilized as a way to understand and improve caregiver perceptions and practices related to HH. A question highlighting HH improvement and the receipt of regular results regarding HH performance was targeted. On the WHO HH Self-Assessment Framework (SAF) the acute-care hospital scored 280 (range of 0 – 500), intermediate, for HH facility level and obtained a satisfactory level of 12 for HH Leadership. On a scale of 1 – 7, 73% of overall participants rated “receiving regular feedback regarding HH performance” ≥ 5 on the WHO HH perceptions survey. Based on this feedback and the WHO HHSAF, the acute-care hospital implemented a multimodal approach to HH practices through a novel framework. This targeted approach illuminated participant values regarding regular feedback on HH performance. In response, infection prevention implemented secret shopper HH cameras that rotate departments in conjunction with frequent rounding on units to provide immediate feedback on HH compliance and missed opportunities. Feedback was provided to floor nurses, nurse managers, and assistant nurse managers. Additionally, a dynamic traveling HH campaign was implemented to socialize the WHO 5 Moments. The campaign asked all staff to participate in HH activities and to renew their commitment to HH through unit specific posters and signatures.