Make Hand Hygiene a 24-7 Priority
There are several initiatives and efforts underway in various units and departments throughout BWH to improve hand hygiene compliance around the clock. Health care-associated infections (HAIs) are one of the top 10 leading causes of death in the United States, and hand hygiene is key to preventing them.
The latest observational data from Infection Control indicates physicians and other staff must increase their hand hygiene compliance on nights and weekends. May and June hand hygiene data, which is available on the Balanced Scorecard, shows that weekday compliance rates are higher than night and weekend rates.
For physicians, observations in May in the inpatient units showed 84 percent compliance with hand hygiene during weekdays, but only 55 percent compliance on weekends. Daytime hand hygiene compliance was 92 percent for weekdays in June for all disciplines in inpatient units, but nighttime hand hygiene compliance was 84 percent, which is below the 90 percent goal.
Initiatives throughout inpatient and outpatient areas are targeting hand hygiene compliance. In Obstetrics and the Connors Center for Women and Newborns, all staff are wearing “Ask me if I washed my hands” buttons to empower patients, visitors and hospital employees to hold all staff with patient/patient environment contact personally accountable for hand hygiene. Multidisciplinary initiatives are underway on several Tower inpatient units, including 8CD, 6B and all of Oncology, 14CD and 9CD, as well as Shapiro 9 and 10. The Emergency Department, ICU Leadership Committee, Nursing Quality, Safety, and Care Improvement Committee, and ambulatory clinics are leading various efforts to increase hand hygiene compliance, too.
“We want all staff to remind one another to use hand hygiene and be open to being reminded themselves. Keeping our patients safe takes teamwork,” said Rose Villarreal, MS, PA-C, of Infection Control.
Proper hand hygiene protocol—using an alcohol-based rub like Purell or washing with soap and water at the appropriate times and using the appropriate technique—reduces the spread of organisms that cause HAIs. The hands of health care providers are the most frequent mode of transmission for organisms that cause HAIs, including multi-drug resistant organisms such as MRSA and VRE. A 2008 study by Hayden et al. found that 52 percent of health care workers contaminated their hands or gloves after touching the environment of a patient colonized with VRE, and 70 percent contaminated their hands or gloves after touching the VRE-colonized patient and that patient’s environment1.