Highlights
- •In the setting of an ambulatory care provincial Canadian cancer centre independent nurse hand hygiene compliance (HHC) auditors provide complementary compliance information to a patient-driven audit process.
- •Overall, patient-driven HHC rates have increased with time and by discipline in most cases.
- •Our patient population indicated the high priority it set on HHC; however, there remained reluctance for patients to remind their care providers to engage in HHC.
Background
We examined the patterns of hand hygiene compliance (HHC) among health care providers
(HCP) as observed by trained nurse and patient auditors over time in an ambulatory
care Canadian provincial cancer agency.
Methods
Nurse and volunteer patient auditors completed separate standardized forms documenting
hand-cleansing opportunities during clinic visits. HHC rates were compared over time
by HCP group and by specialty teams. Observations from 10 calendar quarters were analyzed
from April 2015 to September 2019.
Results
Nurse audit HHC rates ranged from 84% to 96%, encompassing 7,213 opportunities with
no significant time-dependent trends by linear regression (R2 = 2.3E-005, P = .9895). The patient audit HHC rates ranged from 57% to 82%, encompassing 23,402
opportunities, were lower overall compared to the nurse audit (73.6% vs 89.2%, respectively,
P < .0001), but displayed an increasing trend (R2 = 0.5374, P = .0159) over the same 10 time periods. The relative risk ratio for the differences
decreased over time (R2 = .5101, P = .0203). Patients acknowledged the importance of HHC and the audit process, but
were reticent to remind HCP to comply.
Conclusions
The nurse audit measuring HCP HHC before entering and after exiting patient examination
rooms showed persistently high compliance over time whereas the patient-driven audit
measuring HHC within the examination room increased over time suggesting a training
effect upon practice. These measures appeared complementary.
Key Words
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Article info
Publication history
Published online: October 20, 2020
Footnotes
Conflicts of interests: EJB has received consultation fees from Cidara Therapeutics (antifungal drug development) and Merck & Company (antifungal clinical trial adjudication services) for projects unrelated to hand hygiene. All other authors (NK, MW, VB, DP, GW, and JM) report no conflicts.
The project was part of an ongoing collaborative quality of care and patient safety process endorsed by CancerCare Manitoba.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
