A statewide approach to systematising hand hygiene behaviour in hospitals: Clean hands save lives, Part I

Abstract

Objective: To describe the planning and execution of a statewide campaign aimed at improving compliance with hand hygiene practices in New South Wales public hospitals. Design and setting: The campaign was conducted in all area health services (AHSs) in NSW (covering 208 public hospitals) between February 2006 and February 2007. Clinical practice improvement methods and campaign strategies were used to improve the availability and use of alcohol‐based hand rub (AHR) at the point of patient care, using staff champions and local leaders, engaging patients and families, and measuring compliance. Staff were given regular feedback on their performance. Project officers funded by the Clinical Excellence Commission (CEC) provided local project management support and implemented the campaign in a standardised format orchestrated by the CEC. Main outcome measures: Proportion of available beds with secured and unsecured AHR containers nearby; amount of AHR used (based on purchasing patterns). Results: Hospital visits before the campaign identified a lack of appropriately placed AHR at the point of care. The number of AHR containers per available bed in near‐patient locations increased to 13 280/18 951 (70%) after the campaign. The quantity of AHR purchased per month across NSW public hospitals increased from 1477 L to 5568 L (a 377% increase). Conclusion: The CEC was successful in systematising the placement of AHR in all NSW public hospitals at the point of patient care. Although the use of AHR increased substantially, some staff were resistant to changing their hand hygiene practices.

Improvements in hand hygiene across New South Wales public hospitals: Clean hands save lives, Part III

“…The Clean hands save lives campaign was rolled out in all 208 NSW public health care facilities located in 11 health authorities — eight geographical area health services (AHSs), the Children's Hospital at Westmead, the Ambulance Service of NSW and Justice Health. Details of the content of the campaign and timelines are provided elsewhere 8 . The campaign aimed to increase awareness of AHR and improve hand hygiene compliance, with the eventual goal of reducing rates of acquisition of MROs in wards providing clinical care.…”

“…All 208 NSW public hospitals engaged in a 12‐month rigorous campaign, 8 collectively focusing on improving the cornerstone of infection control — hand hygiene. After an initial run‐in period, the average compliance rate of 61% reflected an improvement of 14 PP overall (15 PP in before‐patient compliance and 11 PP in after‐patient compliance).…”

“…In March 2006, the Clinical Excellence Commission (CEC) and New South Wales Department of Health (NSW Health) launched the Clean hands save lives campaign, a statewide campaign with the primary aim of assisting HCWs with hand hygiene compliance before and after contact with patients 7 . Secondary goals (described in detail elsewhere 8 ) included improving the supply of alcohol‐based hand rub (AHR) at the point of patient care, increasing HCWs’ awareness of hand hygiene, surveying patients’ opinions on the importance of hand hygiene and their perceptions of HCWs’ hand hygiene practices, and studying the acquisition of a select number of multiresistant organisms (MROs). This article reports on the impact on hand hygiene compliance of introducing AHR to all wards in all public hospitals in NSW.…”

Culture change for hand hygiene: Clean hands save lives, Part II

“…The results and implementation of the Clean hands save lives campaign in NSW are reported in detail elsewhere 12 . ‐ 14 We report here on surveys of staff, patients and visitors about their perceptions of hand hygiene behaviour during the pre‐ and post‐campaign periods.…”

Statewide hand hygiene improvement: embarking on a crusade

“…The strategy included monitoring of HCWs’ compliance, with performance feedback; using staff “champions” and local leaders; placing reminders in the workplace; engaging patients and their families; and ensuring the availability of AHR at the point of care. This supplement includes four reports that summarise important aspects of the project's management and present early results relating to structures, processes and outcomes 14 . ‐ 17 …”