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Published on: June 7, 2017
Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach
Ahmed Jamal1, G O'Grady, E Harnett
1Service Improvement Unit, The Children's Hospital at Westmead, Westmead, Australia. ahmedj@chw.edu.au
Insights
Implementing a multimodal strategy significantly boosted hand hygiene compliance in a pediatric hospital. This approach led to sustained improvements and a reduction in hospital-acquired infections.
Area of Science:
- Healthcare-associated infection prevention
- Infection control practices
- Public health interventions
Background:
- Hand hygiene is crucial for reducing pathogen transmission in healthcare settings.
- Low adherence to hand hygiene protocols remains a persistent challenge.
- The Children's Hospital at Westmead implemented a state-wide campaign in 2006.
Purpose of the Study:
- To evaluate the impact of a multimodal strategy on hand hygiene compliance.
- To assess the sustainability of improved hand hygiene practices.
- To determine the effect of enhanced hand hygiene on hospital-acquired infections.
Main Methods:
- A comprehensive intervention including leadership support, stakeholder engagement, and accessible alcohol-based hand rub.
- Multifaceted education programs and continuous monitoring of staff adherence.
- Regular feedback of performance data to healthcare professionals.
Main Results:
- Hand hygiene compliance increased from 23% in 2006 to 87% in 2011.
- Sustained compliance was observed over a 4-year period.
- A notable decline in hospital-acquired infections and increased alcohol-based hand rub usage were recorded.
Conclusions:
- A multimodal, evidence-based strategy effectively improved and sustained hand hygiene compliance.
- The established framework provides a model for enhancing infection control in pediatric hospitals.
- Improved hand hygiene is directly linked to reduced healthcare-associated infections.
Background:
Effective hand hygiene has long been recognised as an important way to reduce the transmission of bacterial and viral pathogens in healthcare settings. However, many studies have shown that adherence to hand hygiene remains low, and improvement efforts have often not delivered sustainable results. The Children's Hospital at Westmead is the largest tertiary paediatric hospital in Sydney, Australia. The hospital participated in a state-wide 'Clean hands save lives' campaign which was initiated in 2006.
Intervention:
Strong leadership, good stakeholder engagement, readily accessible alcohol-based hand rub at the point of patient care, a multifaceted education programme, monitoring of staff, adherence to recommended hand hygiene practices and contemporaneous feedback of performance data have significantly improved and maintained compliance with hand hygiene.
Results:
Hand hygiene compliance has increased from 23% in 2006 to 87% in 2011 (p<0.001). Sustained improvement in compliance with hand hygiene has been evident in the last 4 years. A decline in a set of hospital-acquired infections (including rotavirus, multiresistant organism transmission, and nosocomial bacteraemia) has also been noted as hand hygiene rates have improved. Monthly usage of alcohol-based hand rub has increased from 16 litres/1000 bed days to 51 litres/1000 bed days during this same period.
Conclusion:
This project has delivered sustained improvement in hand hygiene compliance by establishing a framework of multimodal evidence-based strategies.
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