The National Patient Safety Goals this year from the Joint Commission include a renewed push to reduce and eliminate healthcare-acquired infections (HAI) in every healthcare setting through increased hand hygiene compliance. The patient safety goals ask providers to make these changes to their current hand hygiene policies:
- Adopt a model from the Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization (WHO) hand hygiene guidelines.
- Assess compliance and set goals for hand hygiene in your facility.
- Create a comprehensive hand hygiene program that fosters a culture of patient safety and hand hygiene compliance.
- Monitor compliance and provide feedback to maintain higher rates of hand hygiene.
Control Infection with Hand Hygiene
Much research has been done on the relationship between hand hygiene and healthcare-acquired infections (HAI). Results demonstrate that hand hygiene is the key to decreasing HAIs and promoting infection control in all healthcare settings.
A variety of methods can be successful in increasing compliance. Unfortunately, results have been difficult to replicate from facility to facility, indicating there isn’t a silver bullet that will work for every organization. Targeting your approach to your facility, using a variety of methods and modalities, is the strategy that will allow organizations to successfully move forward.
A recent literature review cited several key areas that are commonly targeted for increasing hand hygiene:1
- Improving awareness with education
- Unit-level protocols and procedures
- Facility-wide programs
- Multimodal interventions
- Electronic monitoring and providing feedback
Change Behavior with Interactive and Engaging Education
Education campaigns need to be interactive and engaging to be effective, simply providing paper handouts to educate staff isn’t enough to change behavior.1 Our course, Hand Hygiene: The Key to Infection Control, can help you solve this education gap immediately.
It’s also important to assess unique difficulties in your facility to identify areas for improvement.1 Luckily, the most critical element is also the simplest and least expensive: increasing access to alcohol-based hand rubs and sinks for handwashing.
Researchers have also looked at patients’ hands and wondered if they represented a “substantial and unaccounted for mode of transmission”.2 To test this theory, researchers instructed providers to encourage patients to perform hand hygiene with an alcohol-based hand rub while they too performed hand hygiene. The results showed a 51% decrease in MRSA infections at this facility from the previous year.2
Adopt “Co-Washing” for Patient-Centered Care
Another study explored this idea of “co-washing,” encouraging the patient to use an alcohol-based hand rub with the provider. While this study was done on a facility with already high provider hand hygiene compliance rates, they also saw an increase in provider compliance. But, the striking discovery was that patients were willing to perform hand hygiene with the provider 83.7% of the time it was offered.3
Including “co-washing” into your hand hygiene policy could be a way of increasing provider compliance, but to also integrate hand hygiene and the principles of infection control into patient-centered care.
Create a Culture of Safety
Ultimately, the responsibility for hand hygiene falls on each provider or staff member to follow through on their commitment to patient safety. But, the responsibility for moving forward with an organization-wide policy will fall on the leadership of your facility and organization. To that end, the Joint Commission has also issued a sentinel event calling attention to the role of leadership in creating a culture of safety.
World Hand Hygiene Day is May 5th and MedBridge would like to encourage each provider and policymaker to take the next step in their hand hygiene compliance program and create a culture of safety that supports patient-centered care in your organization.
- Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review. Am J Infect Control. 2016 Jun 1;44(6):691-704
- Systematic patients' hand disinfection: impact on meticillin-resistant Staphylococcus aureus infection rates in a community hospital. J Hosp Infect. 2010 Aug;75(4):269-72. Systematic hand hygiene of patients and relatives appears to be an inexpensive and highly effective preventive measure against MRSA nosocomial transmission.
- Patient Attitudes and Participation in Hand Co-Washing in an Outpatient Clinic Before and After a Prompt. Ann Fam Med. 2017 Mar;15(2):155-157. http://www.annfammed.org/content/15/2/155.long