Hand hygiene compliance for patient safety

Purpose – The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance. Design/methodology/approach – A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team. Findings – A modest negative relationship between this leadership style and hand hygiene compliance rates (r=0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style. Research limitations/implications – The sample was relatively small, other attributes of leaders were not investigated. Practical implications – Leadership development for clinicians may need to focus on situational or adaptive capacity rather than a specific style. In the case of improving patient safety through increasing HH compliance, a more directive approach with clear statements backed up by role modelling appears likely to produce better rates. Originality/value – Little is known about patient safety and clinical leadership. Much of the current focus is on developing transformational, authentic or engaging style. This study provides some evidence that it should not be used exclusively.

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Implementation of the Comprehensive Unit-Based Safety Program to Improve Infection Prevention and Control Practices in Four Neonatal Intensive Care Units in Pune, India

Frontiers in Pediatrics ◽

10.3389/fped.2021.794637 ◽

2022 ◽

Vol 9 ◽

Author(s):

Julia Johnson ◽

Asad Latif ◽

Bharat Randive ◽

Abhay Kadam ◽

Uday Rajput ◽

...

Keyword(s):

Patient Safety ◽

Hand Hygiene ◽

Safety Culture ◽

Neonatal Intensive Care ◽

Hand Hygiene Compliance ◽

Patient Safety Culture ◽

Central Line ◽

Infection Prevention And Control ◽

Central Line Insertion ◽

Hygiene Compliance

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate of healthcare-associated bloodstream infection (HA-BSI), all-cause mortality, patient safety culture, and workload.Results: A total of 144 healthcare workers and administrators completed CUSP training. All sites conducted at least 75% of monthly meetings. Hand hygiene compliance odds increased 6% per month [odds ratio (OR) 1.06 (95% CI 1.03–1.10)]. Providers completed insertion checklists for 68% of neonates with a central line; 83% of checklists were fully completed. All-cause mortality and HA-BSI rate did not change significantly after CUSP implementation. Patient safety culture domains with greatest improvement were management support for patient safety (+7.6%), teamwork within units (+5.3%), and organizational learning—continuous improvement (+4.7%). Overall workload increased from a mean score of 46.28 ± 16.97 at baseline to 65.07 ± 19.05 at follow-up (p < 0.0001).Conclusion: CUSP implementation increased hand hygiene compliance, successful implementation of a central line insertion checklist, and improvements in safety culture in four Indian NICUs. This multimodal strategy is a promising framework for low- and middle-income country healthcare facilities to reduce HAI risk in neonates.

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Improving Patient Safety by Increasing Hand-hygiene Compliance and Decreasing Healthcare-associated Infections

American Journal of Infection Control ◽

10.1016/j.ajic.2014.03.291 ◽

2014 ◽

Vol 42 (6) ◽

pp. S135-S136

Author(s):

Cathy S. Sanders ◽

Melissa Cole ◽

Terri Scarborough ◽

Richard Brown

Keyword(s):

Patient Safety ◽

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Healthcare Associated Infections ◽

Hygiene Compliance ◽

Healthcare Associated

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Has Improved Hand Hygiene Compliance Reduced the Risk of Hospital-Acquired Infections among Hospitalized Patients in Ontario? Analysis of Publicly Reported Patient Safety Data from 2008 to 2011

Infection Control and Hospital Epidemiology ◽

10.1086/670637 ◽

2013 ◽

Vol 34 (6) ◽

pp. 605-610 ◽

Cited By ~ 12

Author(s):

Giulio DiDiodato

Keyword(s):

Patient Safety ◽

Hand Hygiene ◽

Acute Care ◽

Poisson Regression ◽

Hand Hygiene Compliance ◽

Acute Care Hospitals ◽

Ordinary Least Squares ◽

Hospital Acquired Infections ◽

Hygiene Compliance ◽

Hospital Acquired

Design.Prospective, observational, ecological, time series, cross-sectional study examining the association between hand hygiene compliance (HHC) rates and the incidence of hospital-acquired infections.Setting.Acute care hospitals (N = 166) located in the province of Ontario, Canada.Methods.All data were extracted from the Ontario patient safety indicator database (http://www.hqontario.ca/public-reporting/patient-safety). Complete data were available for 166 acute care hospitals from October 1, 2008, to December 31, 2011. The rates of Clostridium difficile infection (CDI) are reported monthly, methicillin-resistant Staphylococcus aureus (MRSA) bacteremia quarterly, and HHC rates yearly. Trends and associations for each indicator were evaluated by ordinary least squares regression (HHC), zero-inflated Poisson regression (MRSA bacteremia), or Poisson regression (CDI). Dependent variables included in the regression analyses were extracted from the same database and included year, healthcare region, and type of hospital (teaching or small or large community).Results.Compared to those in 2008, reported HHC rates improved every year both before and after environment/patient contact (range, 10.6%–25.3%). Compared to those in 2008, there was no corresponding change in the rates of MRSA bacteremia; however, the rates of CDI decreased in 2009 but were not statistically significantly decreased from baseline in either 2010 or 2011. No consistent association was demonstrated between changes in the rates of HHC and these two healthcare-associated infections (HAIs).Conclusions.Despite significant improvements in reported rates of HHC among healthcare personnel in Ontario's hospitals, we could not demonstrate a positive ecological impact on rates of these two HAIs.

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