Hand hygiene observations…not so secret anymore

Abstract

Background• Approximately 80% of communicable diseases are transmitted by human hands (CDC)• Tracking hand hygiene compliance (HHC) is an important function in healthcare to monitor compliance and validate accountability.• Using a covert approach to monitoring hand hygiene limits the ability to collect a sufficient number of observations that are non-biased and highly reliable. Methods• Implementation of an overt observation program to collect data and provide real-time feedback to staff at a 900-bed multi-facility academic medical center.• Key Elements of the Program o Paid overt observers o Uniform blue vests o Mobile tablets with an electronic survey tool o Two-way observation (entry and exit) o Immediate verbal feedback o Weekly data distribution Results Conclusions• Overt observers are not unit specific -provide an unbiased perspective when gathering observations• Statistically significant increase in the number of observations collected, improved compliance, and the ability to give and track feedback.• Regularly scheduled observer competencies to ensure accuracy and consistency of each observer. ObjectiveTo create a hand hygiene surveillance program to reduce bias, be more reliable, yield a greater number of observations, and provide real time feedback Covert FY 2015 Overt FY 2016 Overt FY 2017 Overt FY 2018 Hand hygiene compliance 78% 68% 88%* 89%* Total observations 8548 24598 38051 44756 % staff who received verbal feedback N/A N/A 67% 88% Implemented verbal feedback 50% 60% 70% 80% 90% 100% FY16 Q1 FY16 Q2 FY16 Q3 FY16 Q4 FY17 Q1 FY17 Q2 FY17 Q3 FY17 Q4 FY18 Q1 FY18 Q2 FY18 Q3 FY18 Q4Hand hygiene compliance rate % of observations that received feedback Table 2. Hand Hygiene compliance and number of observations by fiscal year. *statistically significant increase in compliance from FY16 to FY17 and FY16 to FY18, p-value <0.001. Figure 1. Graph depicts the hand hygiene compliance from fiscal year 2018 to 2018 and the verbal feedback given during that time period.