Highlights
- •We aim to improve hand hygiene (HH) compliance by pediatric oncology unit visitors.
- •Cycles were 1) visual cue, 2) symptom screen added, 3) verbal HH instructions added
- •Visitors were significantly more likely to perform HH when directly instructed.
- •An anonymous staff survey confirmed the feasibility of the process.
Abstract
Background
Hand hygiene (HH) is the single most important method to prevent infections. We aim
at improving HH compliance by visitors to a pediatric oncology unit.
Methods
A performance improvement project implemented several Plan-Do-Study-Act cycles in
July-November 2018. At baseline, a wall-mounted alcohol-based hand sanitizer dispenser
was available at the unit entrance. Cycle 1 (visual cue), cycle 2 (visual cue plus
verbal symptom screen), and cycle 3 (visual cue, symptom screen, plus HH verbal instructions)
were tested. Patient care associates (PCA) positioned at the entrance implemented
the cycles and recorded data about visitor's estimated age, day and time of observations,
and covert HH compliance monitoring. Participating PCAs were surveyed regarding process
feasibility.
Results
Of 1230 (97%) analyzed observations; 204 (17%) were baseline, 293 (24%) in cycle 1,
374 (30%) in cycle 2, and 359 (29%) in cycle 3. The visitors’ HH compliance significantly
increased to 16.0%, 22.5%, and 48.5% in cycles 1, 2, and 3, respectively, from a baseline
of 4.9% (P < .001). Visitors were more likely to perform HH when directly instructed (cycle
3) compared to baseline (adjusted OR = 19.77, 95% CI, 10.30-42.09, P < .001). Although the surveyed PCAs agreed the process is easy and fast, they reported
few barriers.
Conclusions
Direct verbal instructions for HH were the most effective in improving visitors’ HH
compliance.
Key words
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Article Info
Publication History
Published online: November 27, 2021
Footnotes
Previous presentation: This work was presented in part at the Association for Professionals in Infection Control and Epidemiology (APIC) 2019 annual conference on June 12-14, 2019, in Philadelphia, PA.
Conflicts of interest: None to report.
Identification
Copyright
© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
