Healthcare News & Insights

Hand washing: How one hospital achieved nearly 100% compliance

While hospital staffers know that good hand hygiene is the best bet for cutting down on germs, it may not always be their biggest priority. One hospital came up with a unique, multifaceted strategy for boosting hand-washing rates.

147688442After observing healthcare workers when his wife was in the hospital for surgery, Dr. Gerald Hickson of Vanderbilt University Medical Center decided to take action, according to an article on Yahoo News.

Dr. Hickson noticed many doctors and nurses weren’t always washing their hands when they should. In fact, throughout his wife’s stay at Vanderbilt, he counted over 60 instances where staffers neglected their hand hygiene.

This observation lead him to collaborate with another doctor on Vanderbilt’s staff, Dr. Tom Talbot, to create a hand-washing initiative for the entire hospital.

3 key elements

Vanderbilt already had a traditional hand-hygiene program in place, but it was doing little to improve hand-washing rates. So the doctors took a different approach, focusing on three important areas:

  • Training. Every single hospital employee received training on correct hand-washing protocol, from clerical workers to chief surgeons. The training program placed much of its focus on the direct link between hand-washing and hospital-acquired infections.
  • Communication. Peer-to-peer communication was key to making the program work. Staff members were encouraged to speak up and remind each other of correct hand-washing practices if they noticed lapses. If someone received a reminder, the only correct response was “Thank you.”
  • Shared accountability. All staffers were held equally accountable for their unit’s success with achieving high hand-washing rates, even if they were visiting surgeons. Designated employees were tasked with monitoring how closely everyone followed established protocols, and units that didn’t meet established targets were encouraged to boost their performance as a whole. Staffers were also rewarded based on their collective performance in improving hand-washing rates.

Besides these three aspects, the program also addressed other staffer concerns to improve hand hygiene. Example: Some staff members complained that constant use of hand sanitizer irritated their skin. So the hospital added lotion dispensers for hospital staff to use along with the sanitizer – and told them to only put a dime-sized amount on their skin.

Positive results

Because of this approach, Vanderbilt’s hand-washing initiative has been very successful. In 2009, when the program started, hand-washing rates for staffers were at 58%. This year, they stand at nearly 97%.

And the effects of this program have positively affected another initiative: reducing hospital acquired infections in patients. Since the new hand-hygiene initiative was put into place, urinary tract infections from catheters in the hospital’s ICUs have gone down by 33%, and ventilator-acquired pneumonia has decreased by 61%.

The biggest decrease was in bloodstream infections from central lines – those dropped by 80% in ICUs.

The results of this program show that when it comes to improving hand-washing rates, education alone isn’t enough. Working to change your hospital’s entire safety culture – and to make hand hygiene a priority from the top down – is the wisest route to take.

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