The power of feedback: Implementing a comprehensive hand hygiene observer program

Area of Science:

• Healthcare-associated Infections
• Infection Prevention and Control
• Patient Safety

Background:

• Hand hygiene is critical for preventing infections in healthcare.
• A hospital-wide program used overt observations, real-time feedback, and analysis of hand hygiene misses.
• The program aimed to improve adherence to infection prevention protocols.

Purpose of the Study:

• To evaluate the effectiveness of a hospital-wide hand hygiene program.
• To identify common reasons for hand hygiene non-compliance.
• To enhance communication and awareness regarding infection prevention practices.

Main Methods:

• Conducted over 160,000 hospital-wide hand hygiene observations from 2011 to 2019.
• Trained observers on the WHO's My Five Moments for Hand Hygiene.
• Analyzed observational data by unit, provider type, and thematic reasons for misses.

Main Results:

• Institutional hand hygiene compliance exceeded 95% from 2013 to 2019.
• Thematic analysis identified "touching self" and "touching phone" as frequent causes of hand hygiene lapses.
• The program facilitated better understanding of staff workflows and education on hand hygiene opportunities.

Conclusions:

• Overt observations improved communication and understanding of hand hygiene practices among healthcare staff.
• The program enhanced awareness of infection prevention and control (IPC) practices and patient safety.
• It fostered dialogue around hand hygiene misses and strengthened relationships within the healthcare team.