5 Tips for Improving Hand Hygiene Compliance

Hand hygiene is consistently one of the most challenging parts to patient care, averaging well below 50 percent compliance in many institutions. Here are five things staff in charge of boosting hand hygiene compliance should know for improving the practice in any facility, from Martha Bouk, RN, BSN, CIC, an infection preventionist at Kankakee, Ill.-based Riverside Medical Center and Heather McLarney, vice president of marketing at DebMed.

1. Healthcare workers skip more than 50 percent of all hand hygiene opportunities when using foam-in, foam-out protocols. According to a benchmarking study done by DebMed, the two-step protocol results in only 48 of every 100 hand hygiene opportunities being taken. Programs like the World Health Organization's "My 5 Moments for Hand Hygiene" and the Centers for Disease Control and Prevention's hand hygiene protocols retain the catchy step-wise method while expanding the invitation for healthcare workers to engage in hand hygiene during patient care rather than simply before and after visiting a patient.

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2. One of the most challenging parts to implementing a five-step hand hygiene program is staff education. Implementing change takes a lot of work, especially when that change requires more on the part of the staff. "There are a lot of educational needs, though the end result is a more complete hand hygiene program," says Ms. Bouk. "But, My Five Moments goes along with excellent infection prevention — the gold standard — which is so important in today's healthcare world."

3. Training visuals and catchphrases are key. While foam-in, foam-out is easy to remember, keeping track of five steps can be more difficult. Keep concise visual aids on hand, such as posters, so staff can glance at and memorize the steps. Catchphrases also help keep scenarios in which hand hygiene opportunities crop up in focus.

An equally important part to using catchphrases and visual aids is to keep them new and fresh. "Hand hygiene is basic infection prevention. When you go back over and reiterate basic concepts, nurses can glaze over because they've been hearing those concepts for years. Finding ways to get the message to staff members takes reiteration and time," says Ms. Bouk. She suggests making an effort to rotate posters and other aids on a regular basis.

4. Data can help accelerate the adoption process. Ms. Bouk notes infection preventionists may not have the time they feel they should devote to hand hygiene compliance. Accordingly, she suggests investing in a data collection system for hand hygiene, like the DebMed system used at Riverside Medical Center. Riverside works to maintain posters of data summaries of which nurses should be aware, including the institution's hand hygiene data. "The constant reminder — the actual posters — and data to show how nurses [and other staff] are doing [in terms of compliance] on a routine basis are two of the most important tools available," she says.

5. The location of hand hygiene resources counts. "Having resources at the point of care is a critical part of compliance," says Ms. McLarney. Ms. Bouk agrees. "Time efficiency for staff is the most important part of installing [hand hygiene gel] dispensers," she says. The most efficient locations for hand hygiene depend on each unit's workflow, and what works for one unit may not work for another unit. "Try to standardize placement, so no matter what unit staff are working in, they know where sanitizers are," says Ms. Bouk.

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