Using the Targeted Solutions Tool® to Improve Hand Hygiene Compliance Is Associated with Decreased Health...

Area of Science:

• Healthcare Improvement
• Infection Prevention
• Public Health

Background:

• Memorial Hermann Health System (MHHS) adopted the Joint Commission Center for Transforming Healthcare's Web-based Targeted Solutions Tool (TST) in 2010 to enhance hand hygiene practices across 12 hospitals.
• This initiative was crucial for MHHS's strategy to reduce healthcare-associated infections (HAIs), as hand hygiene is a primary factor in their transmission.

Purpose of the Study:

• To implement and evaluate the effectiveness of the Targeted Solutions Tool (TST) for improving hand hygiene compliance system-wide.
• To assess the impact of improved hand hygiene on the rates of central line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonia (VAP) in intensive care units (ICUs).

Main Methods:

• A system-wide process improvement project was conducted from October 2010 to December 2014, involving 150 inpatient units across 12 MHHS hospitals.
• The TST was utilized to measure hand hygiene compliance, identify barriers, implement interventions, and sustain improvements. Data on CLABSIs and VAP rates in adult ICUs were collected and analyzed concurrently.

Main Results:

• System-wide hand hygiene compliance increased from a baseline average of 58.1% to 84.4% during the improvement phase and reached 94.7% and 95.6% in subsequent control phases (p < 0.0001).
• Concurrently, adult ICU CLABSI rates decreased by 49% (p = 0.024) and VAP rates decreased by 45% (p = 0.045) compared to baseline.

Conclusions:

• MHHS achieved substantial and sustained improvements in hand hygiene compliance, maintaining high levels for 25 months post-implementation.
• The observed reductions in adult ICU CLABSI and VAP rates were associated with the enhanced hand hygiene compliance.