1. Hand Hygiene Compliance and the Rates of Hospital-
Acquired Infections: The Need for Interventions
Lindsay Wenning, MPH
.
Background
Objectives
Materials and Methods
IICU Rates Audit System
Competition Overall Rates
Results
Discussion
Conclusion
The goal of this study was to observe how awareness
interventions affect hand-hygiene compliance among healthcare
workers. Prevention of HAIs is one of the main priorities for
proper patient care, and during audits, it was noted that most
employees complied without hesitation. Was this behavior due
to previously successful instruction? Was this habit formed by
mere muscle memory? What caused this practice to become
second-nature? The objectives for this study were to identify
current rates of compliance and how they occur/are maintained.
Is hand-hygiene adherence a one-and-done tutorial or are
constant reminders required?
Audits were entered into a Microsoft Access database. Hand
sanitizer units were located on the walls outside of every patient
room. Audits were performed during both weekday shifts on
inpatient floors 4, 6, and 8-10. HCW type was chosen from
registered nurse, student nurse, or care technician (RN), medical
doctor, attending, fellow, resident, or medical student (MD), or
ancillary staff, which included pharmacy, radiology, respiratory,
transport, environmental, janitorial, or emergency staff. The
“moment” was typically entrance (1) or exit (4). Interventions
included monthly newsletters, quarterly trainings, and a novel
competition comparing rates on different floors.
Based on the information gathered, infection control staff
should implement interventions among inpatient staff every
month. This would ensure constant communication, even if the
monthly newsletter is not received by all staff members. The
auditing system utilized by Eskenazi works well as an
observational tool. It has shown that compliance reduces HAI
contraction, which holds true for MDROs as well. The current
audit system could be improved by an increase in audits, a
greater availability of night shift observances, and by increasing
hospital-wide awareness /enthusiasm of compliance campaigns.
High compliance rates require constant vigilance.
HAIs contribute greatly to the nation’s overall healthcare
costs. Eskenazi Hospital has been monitoring hand hygiene
compliance and HAI rates since 2012. The data collected
suggests a strong correlation between high rates of compliance
and low rates of HAIs. However, the reverse is also true. This is
why hand hygiene awareness campaigns and interventions
must be constantly administered to inpatient staff. Each time
preventative techniques are shared with healthcare workers,
infection rates decrease. Compliance strategies can be
implemented a variety of ways. HAI prevention reduces the
cost of U.S. Healthcare and protects patients.
•Rates of HAIs decreased as compliance
rates increased
•Also true for incidences of MDROs
•Rates not maintained quarterly without
intervention
•Managerial instruction
•Friendly competition
•Golden Gloves
•Maintaining current system  Eskenazi
reaches national goal of 75% reduction of
HAIs within two years
This study investigated the need for consistent interventions
to raise awareness regarding hand hygiene importance and
methodologies among healthcare workers (HCWs). 1/25
hospital patients experienced at least one HAI, which led to over
720,000 incidences in 2011. ~75,000 of those patients died
during their hospitalization. HAIs are the most common
complications in healthcare and occur in 1/20 patients. In 2002,
HAIs accounted for almost two-million infections, which led to
almost 100,000 deaths and cost the country between $30-40
bullion in acute care facilities. Indirect costs of HAIs (ex: loss of
work) cost the U.S. over $100 billion each year.
Month Schedule and Contender
Jan All Units Compete
Feb Start: Top 2 Units
Mar-Jul Next Top Units 3/7
Aug Monthly Top Unit
Sep Monthly Top Unit
Oct Monthly Top Unit
Nov Final: Monthly Top Unit
Dec Champion Celebration
Beforel Patient
Zone Contact
After Patient /
Patient Zone
Contact
After Body Fluid
Exposure
Before Clean/
Aseptic Procedure
4
3
2
1