Hand hygiene in the nursery during diaper changing

Area of Science:

• Healthcare Quality Improvement
• Infection Prevention and Control
• Nursing Practice

Background:

• Nurses in nurseries require effective hand hygiene protocols during diaper changes to prevent infant infections.
• Existing practices may not consistently adhere to optimal hand hygiene guidelines.
• Standardizing hand hygiene is crucial for patient safety in neonatal care.

Purpose of the Study:

• To enhance hand hygiene practices among nursery nurses during diaper changing.
• To implement and evaluate a revised workflow for hand hygiene.
• To identify and address barriers to effective hand hygiene in the nursery setting.

Main Methods:

• A pre- and post-intervention audit was conducted in a hospital nursery with 15 nurses.
• A revised workflow detailing hand hygiene during diaper changes was introduced.
• Environmental modifications to bassinets and the nursery were implemented based on identified barriers.

Main Results:

• Post-intervention audits showed a 20% improvement in hand washing after diaper changes and a 25% improvement in correct hand rubbing steps.
• Compliance decreased for hand hygiene performed before infant contact and after infant wrapping.
• Significant improvement was noted in hand washing compliance after diaper changes, aligning with the workflow's focus.

Conclusions:

• A workflow effectively standardized some aspects of hand hygiene during diaper changes.
• Pre- and post-implementation audits are valuable for evaluating evidence translation into practice.
• Limited overall success in improving compliance highlights the need for sustained efforts, including environmental adjustments, increased awareness, and clear communication.