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Hand hygiene

Hand hygiene

Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
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Obedience

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According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation, obedience...

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Handwashing II: Pre-procedure and Initial Procedure Steps

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The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
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Updated: May 24, 2026

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens

Published on: June 7, 2017

Positive deviance: using a nurse call system to evaluate hand hygiene practices.

Rita de Cássia Ribeiro de Macedo¹, Eloísa Martins Oliveira Jacob, Vanessa Pio da Silva

¹Intensive Care Unit, Albert Einstein Hospital, São Paulo, Brazil. cassia@einstein.br

American Journal of Infection Control

|March 16, 2012

Summary

A positive deviance (PD) approach using a nurse call system significantly improved healthcare professionals' hand hygiene compliance. This led to sustained increases in alcohol hand sanitizer use and a reduction in device-related infections over two years.

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Area of Science:

Healthcare quality improvement
Infection prevention and control
Nursing practice and patient safety

Background:

Healthcare-associated infections remain a significant concern, necessitating improved hand hygiene compliance among professionals.
Various strategies have been explored to enhance adherence to hand hygiene protocols.
The positive deviance (PD) approach offers a unique framework for identifying and scaling successful practices.

Purpose of the Study:

To evaluate the effectiveness of a nurse call system as a tool within a positive deviance (PD) approach to improve hand hygiene compliance.
To assess the impact of this intervention on alcohol-based sanitizer consumption and device-related infection rates.

Main Methods:

A quasi-experimental study was conducted in two step-down units (SDUs) from September 2008 to December 2010.
Alcohol-based hand sanitizer consumption was monitored using electronic handwash counters.
Nurse visits to patient rooms were tracked via the nurse call system.

Main Results:

Implementation of the PD approach led to sustained increases in alcohol hand rub usage in both units for over two years.
A decreasing trend in device-related infections was observed, particularly catheter-associated urinary infections in the east SDU.
The ratio of alcohol hand rub uses to nurse visits exceeded 2.5 in both units, indicating enhanced hand hygiene practices.

Conclusions:

The PD approach, integrated with a nurse call system, effectively improved hand hygiene compliance among healthcare professionals.
Sustained improvements in sanitizer consumption, nurse visit ratios, and reduced device-related infections were demonstrated over a two-year period.
This strategy offers a viable method for enhancing infection control in clinical settings.