scholarly journals Hand Hygiene In and Out: Compliance and Sustainability Are Possible: 90/90 Program in a Mexican Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s241-s242
Author(s):  
Roxana Trejo González ◽  
Miguel Ángel García Salcido ◽  
Diana Palami Antunez ◽  
Reyna Yacaman Handal
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Positive Influence ◽  
Health Providers ◽  
Starting Point ◽  
Hygiene Compliance

Background: The American British Cowdray Medical Center I.A.P., also known as ABC Medical Center, is a highly specialized hospital and private assistance institution located in Mexico City. The ABC Medical Center implemented hand hygiene policies since around 2009, when Mexico committed to patient security. However, hand hygiene compliance remained low. Methods: The objective of the Hand Hygiene 90/90 program was to increase hand hygiene compliance through an integral strategy including a multidisciplinary team with leaders from different areas (nursing, physicians, human resources, quality, and educators). It was named 90/90 because it aimed to accomplish a 90% hand hygiene compliance among all health providers and hospital staff in 90 days (October 1–December 29) upon entering and exiting patient rooms (ie, In & Out). The Hand Hygiene 90/90 program led by the epidemiology area consisted of 5 specific components: management, supplies, education, monitoring, and social marketing (Fig. 1). For a period of 90 days, several permanent actions were implemented; they had a positive influence on the expected outcome (Fig. 2). Results: The starting point at the ABC Medical Center upon launching the program was 70% compliance. With the Hand Hygiene 90/90 program, the first steady change was observed at the end of November 2012 (ie, the sixth measurement point). An 88% compliance was achieved, all compliance was >50% from this point on. The highest compliance was achieved among health providers (doctors and nurses), followed by administrative staff. At the end of December 2012, 91% compliance was achieved by all health providers and hospital staff. Sustainability has been possible over the years through ongoing hand hygiene campaigns. In the 5 years following the implementation of the program, hand hygiene compliance remained mostly below the 90% standard (Fig. 3). Conclusions: An intervention for continuous improvement and hand hygiene compliance using the WHO 5 Moments was implemented throughout 2018, (in addition to the In & Out program). This intervention also incorporated elements of the WHO Multimodal Strategy 1 to develop a comprehensive hand hygiene program together with new indicators. The ABC Medical Center, with the support and leadership of the Ministry of Health, aims to become an example of institutions that achieve national and international benchmarks in the implementation of patient safety programs that are not only successful but also sustainable.Funding: NoneDisclosures: None

scholarly journals Monitoring Hand hygiene Compliance among Healthcare Workers at a Tertiary Care Center: Use of Secret Observers Is the Way Forward

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S409-S409
Author(s):  
Amar Krishna ◽  
Bhagyashri Navalkele ◽  
Amina Pervaiz ◽  
Aditya Kotecha ◽  
Shahram Maroof ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Performance Feedback ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Medical Center ◽  
Care Center ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Smartphone App ◽  
Hygiene Compliance

Abstract Background Hand-hygiene (HH) is known to be the most effective way to reduce healthcare acquired conditions (HACs). Despite being a simple answer to the complex HAC issue, compliance with HH practice has been abysmal with reported compliance rate of 40% among healthcare workers (HCWs). In 2015, compliance rate with HH at Detroit Medical Center (DMC) was reported to be 100% when direct observers were used to monitor compliance. In order to confirm the previously reported compliance rates, this study used secret observers to audit HH compliance and provide performance feedback to HCWs. Methods A prospective observational study was conducted at DMC from June 2016 to December 2016. Hand hygiene committee was established comprising of Infection Prevention and Hospital leadership members. Trained medical residents were appointed as “secret observers” to provide accurate HH reporting. HH auditing was performed using the smartphone app “Speedy audits” to survey and capture the 5 moments of hand hygiene among HCWs. Compliance reports based on different professions, hospital sites, unit locations and auditors were generated using online web portal and analyzed to determine HH compliance rate. Results During the 7-month study period when secret observers were used, a total of 1229 HCWs were observed. Overall, the HH opportunity compliance rate was 31% (916 complied opportunities /2939 opportunities). Hand hygiene compliance rates drastically fell when secret observers were used (31% compared with 100% in 2015 using direct observers). Based on two major before and after patient contact indications, 1022 compliances were observed from 3343 opportunities (30.5% compliance rate). The other compliance rates were 44% before aseptic procedure, 35% after body fluid exposure and 20% after patient environment contact [Figure 1]. Based on profession, compliance rates were lowest among nurses (613/2058; 30%) and medical students (36/169; 21%) when compared with physicians (445/957; 46%). Conclusion Hand-hygiene monitoring by secret observers with use of smartphone app is a feasible and accurate way for tracking HH compliance. The advantage of generating profession-based and unit-based reports for feedback will help to promote HH awareness and improve adherence rates. Disclosures All authors: No reported disclosures.

scholarly journals HAND HYGIENE COMPLIANCE, KNOWLEDGE AND PERCEPTION AMONG HEALTHCARE WORKERS IN A TERTIARY CARE CENTER IN SOUTH INDIA

2021 ◽  
Vol 9 (07) ◽  
pp. 545-548
Author(s):  
G. Swetha ◽  
◽  
V.V. Shailaja ◽  
S. Rajeshwar Rao ◽  
K. Nagamani ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Workers ◽  
Hand Hygiene Compliance ◽  
Role Model ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Care Workers ◽  
Hygiene Compliance

Aim and objective of the study: To assess the compliance, knowledge and perception among health care workers regarding hand hygiene by conducting regular surveillance and educational programs. This surveillance program objective is to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge and perception among health care workers in a tertiary care center in South India Materials and Methods: It is an observational and knowledge perception study conducted ina tertiary care center, over a period of 6 months (Jan 2018 to June 2018) using WHO tools. Questionnaires were distributed to 180 participants which included Doctors, Nurses, technicians, Residents & Medical students in 5 units of the hospital (3 ICUs and 2 post-operative wards) The study is divided into Pre interventional, Interventional and Post interventional phase. The interventions included.1. Role model training. 2. Lectures with PowerPoint presentations, 3. Posters and charts representing hand hygiene protocols & motivational messages Results: Hand hygiene compliance was observed during 2153 hand hygiene opportunities and knowledge perception was assessed among 180 participants in the pre intervention and 180 participants in the post interventional period. After intervention the Hand hygiene compliance rate significantly improved in two post-operative wards and two ICUs (total four out of five units targeted). In the perception survey improvement in knowledge was observed. Strong smell of alcoholic hand rub was mentioned as a common reason for noncompliance in one ICUs. Some wrong practices like using hand rub over the glove were corrected. Conclusion: The surveillance and training program improved the hand hygiene compliance and knowledge among health care workers in four out of five units intertiary care center. Role model training had the most impact. However consistent and continuous educational and training programs are necessary to further improve and maintain the compliance rates of hand hygiene.

A multimodal intervention to improve hand hygiene compliance in a tertiary care center

2018 ◽  
Vol 46 (7) ◽  
pp. 775-780 ◽  
Author(s):  
Abdul Mannan Laskar ◽  
Deepashree R ◽  
Prasanna Bhat ◽  
Biju Pottakkat ◽  
Sunil Narayan ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Improve Hand Hygiene ◽  
Multimodal Intervention ◽  
Hygiene Compliance

scholarly journals 1189. Effectiveness of Multimodal Intervention Strategies to Improve Hand Hygiene Compliance at an Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S426-S427
Author(s):  
Bhagyashri D Navalkele ◽  
Myrtle Tate ◽  
Jeff Dunaway ◽  
Sheila Fletcher ◽  
Barbara Inman ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Medical Center ◽  
Academic Medical Center ◽  
Intervention Strategies ◽  
Improve Hand Hygiene ◽  
Early 19Th Century ◽  
Study Objective ◽  
Multimodal Intervention ◽  
Hygiene Compliance

Abstract Background Since the early 19th century, hand hygiene (HH) has been recognized as the most important factor in preventing healthcare-associated infections (HAI). Still, improving HH compliance is a major hurdle for most healthcare facilities. Our study objective was to evaluate effectiveness of bundled intervention tools in increasing hand hygiene (HH) compliance. Methods The study was performed at the University of Mississippi Medical Center located in Jackson, MS. A multidisciplinary HH team was established in January 2016. Team members included infection prevention, nurse managers, physician, resident, housekeeping, process engineers, and ancillary staff. Hand hygiene compliance was determined based on room entry and exit observations. Intervention strategies were based on Joint Commission Center’s Targeted Solutions Tool (TST) to identify barriers in HH compliance, standardization of data collection, covert observer training and Just-in-time training of providers. Other strategies implemented included education and feedback, rewards and recognition, and system change measures during the 3-year study period (timeline in Table 1). Hand hygiene compliance was calculated based on number of compliance opportunities/total number of observations. One-way Analysis of Variance (ANOVA) was performed to analyze HH data. We did not assess the concomitant reduction in HAI rates as simultaneous HAI prevention strategies confounded analysis. Results Based on total 95,491 observations performed (January 2016- December 2018), there was a statistically significant improvement in HH compliance during the study period from 66.5% in 2016 to 73% in 2017 and 79.5% in 2018 (P = 0.04). Conclusion At our institution, we observed a 56% improvement in hand hygiene compliance over 36-months timeframe. Multidisciplinary team involvement and multimodal intervention strategies play crucial role in improvement and sustainment of HH compliance. Disclosures All authors: No reported disclosures.

Hand hygiene promotion delivered by change agents—Two attitudes, similar outcome

2020 ◽  
Vol 41 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Yew Fong Lee ◽  
Mary-Louise McLaws ◽  
Loke Meng Ong ◽  
Suraya Amir Husin ◽  
Hock Hin Chua ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Tertiary Care ◽  
Change Agents ◽  
Controlled Study ◽  
Care Hospital ◽  
Hand Hygiene Improvement ◽  
Significant Difference ◽  
Hygiene Promotion ◽  
Hygiene Compliance

AbstractObjective:To assess the effect of peer-identified change agents (PICAs) compared to management-selected change agents (MSCAs) on hand hygiene behavior in acute care.Design:Randomized-controlled study.Setting:Two internal medicine wards of a public, university-affiliated, tertiary-care hospital in Malaysia.Methods:We randomly allocated 2 wards to hand hygiene promotion delivered either by PICAs (study arm 1) or by MSCAs (study arm 2). The primary outcome was hand hygiene compliance using direct observation by validated auditors. Secondary outcomes were hand hygiene knowledge and observations from ward tours.Results:Mean hand hygiene compliance in study arm 1 and study arm 2 improved from 48% (95% confidence interval [CI], 44%–53%) and 50% (95% CI, 44%–55%) in the preintervention period to 66% (63%–69%) and 65% (60%–69%) in the intervention period, respectively. We detected no statistically significant difference in hand hygiene improvement between the 2 study arms. Knowledge scores on hand hygiene in study arm 1 and study arm 2 improved from 60% and 63% to 98% and 93%, respectively. Staff in study arm 1 improved hand hygiene because they did not want to disappoint the efforts taken by the PICAs. Staff in study arm 2 felt pressured by the MSCAs to comply with hand hygiene to obtain good overall performance appraisals.Conclusion:Although the attitude of PICAs and MSCAs in terms of leadership, mode of action and perception of their task by staff were very different, or even opposed, both PICAs and MSCAs effectively changed behavior of staff toward improved hand hygiene to comparable levels.

Variability in the Hawthorne Effect With Regard to Hand Hygiene Performance in High- and Low-Performing Inpatient Care Units

2009 ◽  
Vol 30 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Erol Kohli ◽  
Judy Ptak ◽  
Randall Smith ◽  
Eileen Taylor ◽  
Elizabeth A. Talbot ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Inpatient Care ◽  
Hand Hygiene Compliance ◽  
Hospital Staff ◽  
High Rate ◽  
Hawthorne Effect ◽  
High Performing ◽  
Hygiene Compliance ◽  
The Impact ◽  
Student Intern

Objective.To determine the impact of known observers on hand hygiene performance in inpatient care units with differing baseline levels of hand hygiene compliance.Design.Observational study.Setting.Three inpatient care units, selected on the basis of past hand hygiene performance, in a hospital where hand hygiene observation and feedback are routine.Participants.Three infection control practitioners (ICPs) and a student intern observed hospital staff.Methods.Beginning in late 2005, the 3 ICPs, who were well known to the hospital staff, performed frequent, regular observations of hand hygiene in all 3 inpatient care units of the hospital, as part of routine surveillance. During the study period (January-May 2007), a student intern who was unknown to the hospital staff also performed observations of hand hygiene in the 3 inpatient care units. The rates of hand hygiene compliance observed by the 3 ICPs were compared with those observed by the student intern.Results.The 3 ICPs observed 332 opportunities for hand hygiene during 15 observation periods, and the student intern observed 355 opportunities during 19 observation periods. The overall rate of hand hygiene compliance observed by the ICPs was 65% (ie, in 215 of the 332 opportunities, the performance of proper hand hygiene by hospital staff was observed), and the overall rate of hand hygiene compliance observed by the student intern was 58% (ie, in 207 of the 355 opportunities, the performance of proper hand hygiene by hospital staff was observed) (P = .1). Both the ICPs and the student intern were able to distinguish between inpatient care units with a high rate of hand hygiene compliance (hereafter referred to as high-performing units) and those with a low rate (hereafter referred to as low-performing units). However, in the 2 high-performing units, the ICPs observed significantly higher compliance rates than did the student intern, whereas in the low-performing unit, both the ICPs and the student intern measured similarly low rates of hand hygiene compliance.Conclusions.Recognized observers are associated with higher rates of hand hygiene compliance, even in a healthcare setting where such observations have become routine. This effect (ie, the Hawthorne effect) is more pronounced in high-performing units and insignificant in low-performing units. The use of unrecognized observers may be important for verifying high performance but is probably unnecessary for documenting poor performance. Moreover, the Hawthorne effect may be a useful tool for sustaining and improving hand hygiene compliance.

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