An Interdisciplinary Approach to Improving Hand Hygiene Compliance

Purpose:
An interdisciplinary team was developed to implement a unit wide campaign to improve hand hygiene compliance. The purpose of the campaign was to establish routine hand hygiene practices and provide a safe environment by decreasing the opportunity for transmission of nosocomial infections.

Significance:
Prevention of nosocomial infections requires a systematic, multidisciplinary approach, which usually can be achieved under the leadership of an institutional infection-control program. The implementation of an optimal program may decrease the incidence of Nosocomial infections by 30 to 50 percent.

Strategy and Implementation:
Base line data revealed 53% compliance in hygiene practices. An interdisciplinary approach was needed to enhance knowledge and improve compliance among all staff who have patient contact. Representatives from Nursing, Physicians, Human Resources, Strategic Services, Ancillary Departments, and Infection Control developed a campaign guided by the Joint Commission's “Wash In, Wash Out” program. The team's innovative approach included multiple reward systems for compliant behavior, a disciplined approach to consistent real-time feedback, creation of a daily audit calendar and support from senior management and physicians. Senior management team members participated in “100% compliance days” which consisted of rounding on the unit, talking to staff about the importance of hand hygiene, and rewarding compliance by giving staff prizes. Also, if witnessed completing hand hygiene, staff received a raffle ticket to win tickets to a local hockey game.

Evaluation:
Since the implementation of the program, the surgical unit's hand hygiene compliance has risen to 70%. The unit has seen a 50% reduction in C-difficile transmission rate and a total hospital acquired infection rate reduction of 37.5% in the quarter following implementation of this intervention.

Implications for Practice:
Despite a lower than expected compliance rate, implementation of an innovative hand hygiene campaign has improved practice and decreased transmission of nosicomal infections. Real-time feedback, a rewards program, and staff engagement are all important pieces to a successful quality outcome.