ISSUE: Since Ignaz Semmelweis first demonstrated the effectiveness of hand hygiene
in reducing instances of puerperal sepsis, hand hygiene has been the key concept in
reducing the transmission of organisms. Despite the availability of hand sanitizers
in the hallways and reminders by Infection Control personnel, compliance with hand
hygiene at our institution was similar to trends of low hand hygiene compliance as
PROJECT: In 2004, the Infection Control Department, in conjunction with Quality Management,
initiated a hospital wide hand hygiene campaign, whose goal was to improve staff compliance
with hand hygiene. One nursing unit volunteered to be the initial “kick-off” unit.
Staff determined how to implement the initiative on their unit. They were empowered
to intercede with any health care worker who missed a hand hygiene opportunity. Education
via lectures and glow-in-the-dark handwashing demonstrations started the campaign.
A hospital-wide slogan contest for the campaign was held with a prize awarded for
the winning slogan. Physician Champions of Hand Hygiene promoted hand hygiene during
rounds and physician presentations. Other initiatives to increase awareness hand hygiene
included letters to Chairman, publishing in facility newsletter pictures of Administrators
“caught in the act” performing hand hygiene, and rewards to employees observed performing
hand hygiene. Data from anonymous observations were compiled weekly and results provided
to the unit in a trending graph.
RESULTS: As a result of staff-driven unit-based hand hygiene initiatives, observations
of physicians, nurses and patient care associates demonstrated improvement in compliance
with hand hygiene. Overall mean compliance went from a baseline of 34% in March 2004
to an improved rate of 80% that was sustained and was the impetus for expansion of
the campaign to additional units in September 2005. The initial unit's recommendation
to place hand sanitizers in each patient room was implemented.
LESSONS LEARNED: Personal “buy-in” and unit self-determination, in addition to education
and feedback of compliance data, are key in implementing a successful hand hygiene
campaign. Hand hygiene education and reminders to staff continue to maintain increased
compliance and guarantee success.