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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hand hygiene: back to the basics of infection control.Indian J Med Res. 2011; 134: 611-620
- The effect of incorporating covert observation into established overt observation-based hand hygiene promotion programs.Am J Infect Control. 2019; 47: 482-486
- Quantitative impact of direct, personal feedback on hand hygiene technique.J Hosp Infect. 2015; 91: 81-84
- Automated and electronically assisted hand hygiene monitoring systems: a systematic review.Am J Infect Control. 2014; 42: 472-478
- My five moments for hand hygiene': a user-centered design approach to understand, train, monitor and report hand hygiene.J Hosp Infect. 2007; 67: 9-21
- Face touching: a frequent habit that has implications for hand hygiene.Am J Infect Control. 2015; 43: 112-114
- Mobile phones: Reservoirs for the transmission of nosocomial pathogens.Adv Biomed Res. 2015; 4: 144
- Hand-hygiene practices in the operating theatre: an observational study.Br J Anaesth. 2011; 107: 553-558
- Hand hygiene and aseptic techniques during routine anesthetic care - observations in the operating room.Antimicrob Resist Infect Control. 2015; 4: 5
- Hand hygiene in the operating room: the final frontier.Am J Infect Control. 2017; 45: S102-S103
- Barriers, perceptions, and adherence: hand hygiene in the operating room and endoscopy suite.Am J Infect Control. 2017; 45: 695-697
- Hand hygiene in pediatric and neonatal intensive care unit patients: daily opportunities and indication- and profession-specific analyses of compliance.Am J Infect Control. 2011; 39: 732-737
- An observational study of the hand hygiene initiative: a comparison of preintervention and postintervention outcomes.BMJ Open. 2013; 3e003018
- Characteristics of inpatient units associated with sustained hand hygiene compliance.J Patient Saf. 2021; 17: e1272-e1277
- Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series.BMJ Qual Saf. 2012; 21: 1019-1026
- Monitoring hand hygiene via human observers: how should we be sampling?.Infect Control Hosp Epidemiol. 2012; 33: 689-695
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.