Highlights
- •Overt observations and timely feedback provide reliable and efficient Hand hygiene (HH) monitoring.
- •Observer visibility allows for dialogue around the observation process and HH moments.
- •Transparency around observer presence encourages dialogue around improvement.
- •Leadership engagement strengthened relationship between HH observers and clinicians.
Background
Hand hygiene (HH) is a fundamental component of infection prevention within all healthcare
settings. We implemented a hospital-wide program built on overt HH observation, real-time
feedback, and thematic analysis of HH misses.
Methods
A robust observer training program was established to include foundational training
in the WHO's My Five Moments of HH. Observational data from 2011 to 2019 were analyzed
by unit, provider type, and thematic analyses of misses.
Results
During the study period, we conducted 160,917 hospital-wide observations on 29 units
(monthly average of 1,490 observations). Institutional compliance remained above 95%
from 2013 to 2019. Thematic analysis revealed “touching self” and “touching phone”
as common, institution-wide reasons for HH misses.
Discussion
Overt observations facilitated communication between HH program and healthcare staff
to better understand workflow and educate staff on HH opportunities. This program
is an integral part of the Infection Prevention team and has been deployed to collect
supplemental data during clusters and outbreaks investigations.
Conclusions
In addition to having rich HH data, successes of this program, include increased awareness
of IPC practices, enhanced communication about patient safety, enriched dialog and
feedback around HH misses, and relationship building among program observers, unit
staff and leaders.
Key words
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Article info
Publication history
Published online: June 09, 2022
Footnotes
Conflicts of interest: Paid contract with PDI, APIC liaison to HICPAC, Solutions for Patient Safety IP Advisory Group; Public Policy Chair for APIC; APIC Chapter 15 Board Member (President-2021); APIC Annual Conference Committee Member (Vice Chair of Abstract Committee-2021).
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
