TITLE

INCREASING HAND HYGIENE COMPLIANCE REQUIRES CULTURE CHANGE

AUTHOR(S)
Treon, Michelle; Kelley, Kristen; Kneebone, Patricia; Miles, Regina
PUB. DATE
March 2007
SOURCE
Oncology Nursing Forum;Mar2007, Vol. 34 Issue 2, p574
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
An estimated 90,000 deaths occur yearly from hospital-acquired infections. Transmission of pathogens often occurs via contaminated hands. Hand hygiene is a simple and effective intervention to reduce the spread of infection. Despite this common knowledge, providers disregard this intervention. Compliance by providers with recommended hand hygiene procedures has remained unacceptable. One type of hospital-acquired infection is a central venous catheter (CVC) infection. Reduction by 90% would save 225,000 patients from experiencing this complication, and $5.63 billion dollars saved nationally. To design an innovative educational intervention to increase awareness of infection control practices, and increase hand hygiene compliance. Interventions targeted multidisciplinary providers on the adult Hematology/Oncology unit. The project was lead by the Clinical Nurse Specialist, Infection Control Practitioner, and Outcome Specialist with participation from the unit staff and Unit Manager. A Likert survey was created for staff to determine degree of compliance aligning with knowledge of infection control. Survey questions were written to elicit honest answers and evoke a self-assessment. Second, an interactive hand culturing experiment occurred. Anonymous volunteers performed hand hygiene, touched common unit surfaces, and placed their hands on blood agar plates. Photographs of the cultures and organism identification were captured. Next, a Glow-germ experiment was completed to visually evaluate the cleanliness of provider's hands. Commonly missed areas included fingernails, around rings, and wrists. Finally, a poster was created for the hospital's nurses' week activities. The poster contained facts, pictures of correct and incorrect infection control practices, pictures and results of the hand culture experiment, and information on organization infection control policies. The poster was also displayed on the Heme/Onc unit and with a poster post-test. Hand hygiene observation audits completed by the hospital's infection control practitioners revealed an increase in compliance, with rates starting at 35% and ending at 95%. Concurrently noted was a decreasing incidence of CVC infections, and an overall descending trend since January 2004. Although the project overlapped with organizational education, the rate of compliance on this unit significantly out-paced other clinical areas. Before a culture change can occur, creativity and innovation are crucial for reaching success.
ACCESSION #
28835490

 

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