Implementing a hand
hygiene program that's rooted in the four E's engage
educate, execute and evaluate is a great way to get
your health care facility on the path to continuous quality improvement.
In this first video of our four part series, we will cover
an essential facet of an effective program engaging health care personnel.
Hand hygiene programs are complex, involving
all areas of the facility and health care personnel.
There are some common elements found in successful programs
that can help you engage all personnel and encourage participation
in hand hygiene program activities.
Begin by making sure that the health care personnel have everything
they need to clean their hands within reach while they work.
Alcohol based hand sanitizer dispensers
should be clearly visible, with at least two for each patient.
Room one in the hallway for use when entering and exiting a room
and one inside the room for use during patient or resident care
in common areas or areas housing multiple patients or residents.
Consider having one dispenser for every two beds.
Hand-washing stations with warm water, soap and paper towels
should also be within the workflow of personnel.
Health care personnel
often perform hand cleaning by habit when going in and out of rooms.
That's great, but what about those indications that occur
during a patient or resident encounter?
Personnel can work together to help one another remain
aware of times when hands should be cleaned during care.
Two examples are cleaning hands immediately prior
to an aseptic task and immediately after removing gloves.
Encourage personnel to pay attention to instances
when they should have cleaned their hands but were unable to do so.
What kept them from cleaning their hands and power them to share their ideas
about how to improve the hand hygiene program with their supervisor.
While aspirational goals should be grounded in reality,
imagine the possibilities if all limitations
to cleaning hands at the right times were removed.
Goals can focus on outcomes like ensuring that supplies for hand
cleaning are always accessible inside and outside of all rooms.
Goals can also focus on processes like educating
all personnel on how to keep each other accountable.
If a lapse in hand cleaning is observed to achieve
goals, set concrete incremental targets
that will build momentum towards achieving the intended result.
For example, targets for adherence to hand cleaning may include
conducting daily or weekly audits to ensure that all patient
or resident areas have accessible and functional hand cleaning supplies,
creating a way for personnel to report barriers to hand cleaning
and encouraging them to communicate when help is needed.
Engaging unit or department specific leaders in goal setting
for the areas they oversee and to monitor progress towards achieving those goals.
Developing a
culture of kind, accountability, and teamwork in which leaders value
the input of personnel.
Whether it's cleaning your hands at the right times, training others,
or monitoring performance.
Everyone has a part to play in maintaining hand hygiene
at your facility, regardless of the hand hygiene activity.
Establishing accountability is essential.
Accountability can be formally established through inclusion
in job descriptions and evaluations informally.
Health care settings that value a culture of safety engage personnel
by encouraging them to hold one another accountable in a supportive manner.
This might include speaking up to remind colleagues to wash their hands.
Conducting Checklist observations during high risk procedures
like central line insertion.
Or participating in a range of performance improvement
activities.
A great way to begin the process of implementing a continuous quality
improvement program for hand hygiene is to evaluate
how engaged are personnel at your facility.
Start by asking a few simple questions.
Are supplies for hand cleaning
readily accessible and functional at all appropriate locations?
Is hand cleaning included and monitored in prevention bundles
for high risk bedside procedures such as inserting a central line?
Is participation in hand hygiene initiatives included in job
descriptions and evaluations of employees that interact with patients?
Are your hand hygiene program goals informed by challenges
experienced by personnel in various units and departments within your facility?
To improve the hand cleaning practices of your health care personnel
build the foundation of Excellence by ensuring access to supplies,
creating awareness of the times, hands should be cleaned.
Developing aspirational goals and holding personnel accountable.
When these elements come together, hand hygiene programs
can produce meaningful outcomes that support health care personnel
in caring for the populations they serve.
For more information about
hand hygiene, watch the remaining videos in this four part series.
Or visit our website at cdc.gov/handhygiene