The Challenge
Poor hand hygiene among HealthCare Workers (HCWs) is recognised as being the largest problem associated with healthcare-associated infections (HAIs) within hospital environments.
The clean hands are life savers program aims to improve hand hygiene compliance of healthcare workers in acute care settings. The program aims to change healthcare workers behaviour and Queensland Health culture to ensure hand hygiene is a high priority.
Key Facts about Hand Hygiene
- HAIs (healthcare-associated infections) pose a serious threat to all who are admitted to hospital
- Micro-organisms are readily transmitted on HCW's hands and hand hygiene substantially reduces this transmission
- On average, infections complicate 7% to 10% of hospital admissions with most of these infections being preventable.
- Hand hygiene guidelines are well established but evidence shows that compliance is significantly low (under 50%)
- The economic burden is considerable with HAIs in Australia costing at least $400 million annually and causing at least 7,000 deaths with inpatients having one or more HAIs during their stay.
- Research has shown the hand hygiene issue is about human behaviour, organisational culture and leadership and requires a multifaceted approach to achieve improved hand hygiene compliance
Factors affecting Compliance
A number of factors which affect compliance have been reported including:
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Environmental factors - such as sinks inconveniently located and / or not available
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Hierarchical factors - such as a lack of clinical role models
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Psychological Factors - such as insufficient time for hand hygiene due to high work load and understaffing
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Educational Factors - such as the perception that glove use dispenses with the need for additional hand hygiene
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Physical Factors - such as hand hygiene agents causing skin irritation and dryness
The solution is complicated but reachable. Research has shown:
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No single intervention - education, feedback, education and feedback combined, or administrative mandate - has consistently been shown to increase compliance significantly or to sustain improved compliance.
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A multi-level, multidisciplinary, multi-modal program focused on staff is recommended, which must involve a combination of education, motivation, leadership, organisational culture and system change.
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True behavioural change does not occur by targeting the individual alone; environmental constraints, such as access to hand hygiene facilities and organisational climate, such as feedback and positive reinforcement must also be addressed.
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