Highlights
- •Overt observations and timely feedback provide reliable and efficient 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
Abstract
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 Hand Hygiene. Observational data from 2011-2019 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 1490 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.
Conclusion
: 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.
Keywords
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