A quality improvement project at a Missouri academic medical center was able to improve hand hygiene compliance and decrease central line-associated blood stream infections by focusing on four key areas, according to a study in the American Journal of Infection Control.
The quality improvement team implemented several changes in each area, detailed below:
- Staff education
- Put new screensavers in to remind staff about hand hygiene between glove use
- Create new training modules for annual educational purposes
- Reeducate all nurses on use of hand hygiene between glove use
- Reeducate the dietary staff about hair netting and hand hygiene
- Staff accountability
- Compliance monitoring of hand hygiene
- Individual disciplinary action for failure to practice proper hand hygiene
- Hand sanitizer product selection and accessibility
- Replace all sanitizers with an 85 percent ethyl alcohol product
- Place stickers on all sanitizer dispensers with a phone number to call to refill or replace
- Organizational culture
- Include hand hygiene education for medical students and residents
- Engage patients and families in hand hygiene efforts with tip sheets on proper hand hygiene and encourage them to remind healthcare workers of proper hand hygiene protocol
After implementing the four-pronged program over a six-year span, hand hygiene adherence increased from 58 percent in April 2006 to 98 percent in September 2012. Additionally, rates of CLABSIs decreased from 4.08 per 1,000 device days to 0.42.