All Hands on Deck: Sustaining Improved Hand Hygiene Compliance in the Operating Room

2021 ◽  
pp. 106480462199509
Author(s):  
Orysia Bezpalko ◽  
Siddarth Ponnala ◽  
James C. Won
Keyword(s):  
Hand Hygiene ◽  
Operating Room ◽  
Hand Hygiene Compliance ◽  
Complex Environments ◽  
Expectancy Value ◽  
Hands On ◽  
Effort Expectancy ◽  
Systemic Factors ◽  
Hygiene Compliance ◽  
Value Model

Hand hygiene is an essential component of infection prevention in the health care setting. Despite diligent efforts, clinicians can be susceptible to hand hygiene misses in fast-paced, complex environments such as the operating room due to systemic factors such as the physical environment, workflow, and sporadic interactions with other personnel. Through the use of human factors and resilience engineering concepts, work-as-done were studied to identify barriers to hand hygiene compliance in the operating rooms of a pediatric hospital in an urban area. The saliency, effort, expectancy, value model was applied to design a multifaceted intervention that resulted in a sustained 95% hand hygiene compliance.

Sleep safe in clean hands: Improving hand hygiene compliance in the operating room through education and increased access to hand hygiene products

2019 ◽  
Vol 47 (5) ◽  
pp. 504-508
Author(s):  
Elizabeth T. Paul ◽  
Michele Kuszajewski ◽  
Ashley Davenport ◽  
Julie A. Thompson ◽  
Brett Morgan
Keyword(s):  
Hand Hygiene ◽  
Operating Room ◽  
Hand Hygiene Compliance ◽  
Hygiene Compliance

scholarly journals The Process of Developing and Implementing a Simplified Guideline for Hand Hygiene in the Operating Room

2020 ◽  
Vol 41 (S1) ◽  
pp. s410-s410
Author(s):  
Manon van Dijk ◽  
Mieke Waltmans-den Breejen ◽  
Joke Vermeeren ◽  
Sonja van den Berg ◽  
Ed van Beeck ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Operating Room ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Medical Center ◽  
Outpatient Setting ◽  
Pilot Test ◽  
Policy Document ◽  
Time Points ◽  
Hygiene Compliance

Background: Most studies on improving hand hygiene compliance (HHC) focus on clinical wards. The 5 Moments of Hand Hygiene, as stated by the WHO, are less easy to identify in an outpatient setting or procedure rooms. Therefore, observing compliance of these moments in an outpatient clinic or among healthcare workers (HCWs) in the operating room (OR), is far more difficult. Nonetheless, proper hand hygiene in the OR is of utmost importance to prevent postoperative wound infection. Objective: We developed and implement a scoring instrument with simplified moments of hand hygiene for nonsterile HCWs in the OR. Methods: All 13 hospitals of the Antibiotic Resistance Network Southwest Netherlands were asked to submit their guidelines on hand hygiene in the OR. These guidelines were, after discussion, combined into 1 guideline, describing different hand hygiene areas for different groups of nonsterile HCWs in the OR. After asking for feedback and incorporating these adjustments, the guideline was converted into a policy document. Based on this document, a paper scoring instrument was developed to observe HHC in the OR in a uniform way across all hospitals. The Erasmus University Medical Center Rotterdam, the Netherlands (Erasmus MC) acted as a pilot hospital where the implementation of the scoring instrument was studied. Results: The policy document has been approved by the infection committees of all 13 hospitals. The preliminary data of the pilot in the Erasmus MC, although still ongoing, are as follows. Hand hygiene in the OR was observed at 4 different time points. The anesthetist was observed once during 4 procedures in 3 different ORs. At the other 3 time points, the OR assistants (ie, OR nurses and circulating nurses) were observed during 4 procedures in 4 different ORs. Hand hygiene moments were easy to identify; the paper scoring instrument could be used to record observations of HHC in the OR. Conclusions: The guideline with the simplified moments of hand hygiene for nonsterile HCWs in the OR has been successfully implemented. The pilot test in the Erasmus MC already showed that, after defining the hand hygiene moments in the OR, the HHC in the OR is easier to observe and record using the scoring instrument. Moreover, the instrument has provided clarity for HCWs regarding the moments ate which they should disinfect their hands.Funding: NoneDisclosures: None

scholarly journals Reducing health care–associated infections by implementing a novel all hands on deck approach for hand hygiene compliance

2016 ◽  
Vol 44 (5) ◽  
pp. e13-e16 ◽  
Author(s):  
Emily E. Sickbert-Bennett ◽  
Lauren M. DiBiase ◽  
Tina M. Schade Willis ◽  
Eric S. Wolak ◽  
David J. Weber ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Hands On ◽  
Health Care Associated Infections ◽  
Hygiene Compliance

scholarly journals Everybody hands-on to avoid ESKAPE: effect of sustained hand hygiene compliance on healthcare-associated infections and multidrug resistance in a paediatric hospital

2018 ◽  
Vol 67 (12) ◽  
pp. 1761-1771 ◽  
Author(s):  
Daniela De la Rosa-Zamboni ◽  
Sara A. Ochoa ◽  
Almudena Laris-González ◽  
Ariadnna Cruz-Córdova ◽  
Gerardo Escalona-Venegas ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Healthcare Associated Infections ◽  
Paediatric Hospital ◽  
Hands On ◽  
Hygiene Compliance ◽  
Healthcare Associated

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals Hand hygiene and the sequence of patient care

2021 ◽  
pp. 1-6
Author(s):  
Nai-Chung Chang ◽  
Michael Jones ◽  
Heather Schacht Reisinger ◽  
Marin L. Schweizer ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Patient Care ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Resistant Bacteria ◽  
Surgical Intensive Care ◽  
Hygiene Compliance ◽  
Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

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