Using targeted solution tools as an initiative to improve hand hygiene: challenges and lessons learned

Area of Science:

• Healthcare Quality Improvement
• Infection Prevention and Control
• Health Services Research

Background:

• Low hand hygiene compliance is a significant contributor to healthcare-associated infections.
• Effective monitoring and intervention strategies are crucial for improving patient safety.

Purpose of the Study:

• To evaluate the impact of the Targeted Solutions Tool (TST) on hand hygiene compliance rates.
• To identify factors contributing to non-compliance with hand hygiene protocols.
• To assess the correlation between improved hand hygiene and reduced healthcare-associated infections.

Main Methods:

• Implementation of a web-based Targeted Solutions Tool (TST) for hand hygiene improvement.
• Monitoring of hand hygiene compliance through trained unknown and known observers (5669 observations).
• Tracking of healthcare-associated infection rates, including Clostridium difficile, central line-associated bloodstream infections, and catheter-associated urinary tract infections.

Main Results:

• Hand hygiene compliance increased from 75.4% at baseline to 88.6% during the intervention and control periods (P < 0.0001).
• Reductions observed in infection rates: C. difficile (7.95 to 1.84), CLABSI (5.9 to 2.9), and CAUTI (5.941 to 0 per 1000 device days).
• Key non-compliance factors identified: improper glove use, hands full, and frequent entry/exit from isolation areas.

Conclusions:

• The Targeted Solutions Tool (TST) is effective in enhancing hand hygiene compliance within healthcare organizations.
• TST facilitates the identification of specific barriers to hand hygiene, enabling targeted interventions.
• Improved hand hygiene compliance is associated with a reduction in healthcare-associated infections.