Effects of Peer Monitoring and Peer Feedback on Hand Hygiene in Surgical Intensive Care Unit and Step-down Units

Abstract

Attempts to increase hand hygiene compliance of health care workers solely through education have met with mixed success. A peer-monitoring and feedback intervention was evaluated to determine the effectiveness in increasing hand hygiene among health care staff at a large teaching hospital. Comparisons of pre- (n = 263) and post- (n = 253) observations revealed that the intervention had a significant effect on increasing hand hygiene compliance after nonpatient contact in a patient's room (P = .006).

Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital

“…Interestingly, we also observed a statistically significant compliance increment in the second trimester of the baseline phase, which is probably due to the observer effect , while the improvement in the second trimester of the post-intervention phase might be due to a combination of peer monitoring and peer feedback. As shown in other studies [27, 28], such increase may confirm that approaches creating an environment that promote and motivate HCWs to change can contribute to a more effective and lasting improvement in compliance.…”

Monitoring teamwork: a narrative review

“…Teamwork training was not found to be universally effective. Peer feedback was seen to improve hand hygiene in intensive care for the nurses (63–83%) but not for medical staff (24–20%) .…”

“…This review identified a consistent pattern of results of improving teamwork using different methods and from different institutions. Failures to show improvements were present , but were less commonly described. These patterns mirrored those shown in non‐healthcare research that was identified but not reported in this review.…”

The prevention, treatment, and outcomes of Staphylococcus aureus infections

“…They found active surveillance culturing was performed on only 32% of eligible patients and the mean rate for adherence to hand hygiene was 59% for nurses and 41% for doctors (200). Some investigators have found that the combination of monitoring adherence and reporting the results back to staff helps healthcare workers improve their performance (196,197,201). Jamal et al reported that healthcare workers on different units began competing with each other when hand hygiene adherence rates were provided to all units (196).…”

“…Jamal et al reported that healthcare workers on different units began competing with each other when hand hygiene adherence rates were provided to all units (196). Langston et al reported a significant increase in hand hygiene adherence after contact with objects or surfaces in patients' rooms when peers monitored and fed back adherence rates to staff in the surgical intensive care unit, neurosurgery intensive care unit, and the surgical intermediate care unit (201). A substantial proportion of IPs in our study reported that their hospital implemented a specific bundle component, but did not monitor adherence and report results to staff for that component.…”