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Spend a few minutes quietly observing from almost any corner of the hospital, and you’ll see a common theme: hand hygiene is embedded in BWH’s culture, no matter the unit, department or floor. It’s not surprising, then, that BWH’s hand hygiene compliance rates are at an all-time high, and they continue to climb every month.
In January, hand hygiene inpatient compliance was at 95.5 percent—five percentage points above what it was in January 2010. The upward trend continued in February, hospital-wide: in non-ICU units, hand hygiene compliance was at 95 percent, with nearly 20 units achieving 100 percent compliance. And in the ICU, which had an overall compliance rate of 95 percent, six units achieved 100 percent compliance.
“Hand hygiene is the number one way to prevent infection,” said Regina Piszcz, hand hygiene coordinator. “Our focus remains on helping people to make it part of their everyday routine, as we remind people how simple it is to practice good hand hygiene and what a big impact it has on infection prevention.”
According to medical director of Infection Control at BWH and DFCI Deborah Yokoe, MD, the high compliance scores are the results of consistent messaging and education efforts that began nearly a decade ago.
“A huge amount of collaborative effort went into helping staff to make the connection between consistent hand hygiene and preventing patient infections,” said Yokoe. “Now, everyone knows it is an essential component for providing quality patient care.”
During the past 10 years, Yokoe said, education efforts included presentations at rounds and consultations with units throughout the hospital.
“The team also thought of creative ways to convey this information to our audiences,” Yokoe said, explaining that they used methods such as letting staff imprint their unwashed hands on microbiology culture plates and showing the subsequent growth of colonies of bacteria to serve as a compelling visual. “But, perhaps one of the most important things we did was bringing together multidisciplinary groups to think about how to improve hand hygiene in their particular areas. Different areas work differently, and you have to think about what works best for your own area and your own group.”
In Nursing, efforts to embed hand hygiene into the culture included making sure Purell was easily accessible and celebrating hand hygiene successes, such as profiling nurse champions who achieved high compliance rates. Ultimately, hand hygiene was driven by a “be patient ready” message, explained Colleen West, MBA, BSN, RN, CPHQ, nursing quality program director. The “be patient ready” slogan was developed by the Hand Hygiene Improvement Team; a partnership with Nursing Quality Safety and Care Improvement Committee members, Infection Control Practitioners and Support Services.
“A lot of times, people would go in to consult with a patient and, thinking they weren’t going to have contact with the patient, they would not perform hand hygiene,” West said. “Then once they got in there, if they did need to have contact, they had missed that step. We’re seeing that the ‘be patient ready’ thought process has made a difference in many areas, and it has definitely contributed to the positive change at BWH.”
Save Lives, Clean Your Hands The World Health Organization celebrates Hand Hygiene Day on May 5. Visit an informational table on the Mezzanine outside Shop on the Pike for giveaways, quizzes and more information about hand hygiene efforts.