ITS 73 - Hand Hygiene Performance Improvement Results in Adult Acute Care Units After 52-weeks of a Novel Intervention Program

Background: This 667-bed quaternary care medical center is a complex facility with a wide variety of services and many high acuity patients. Leadership selected hand hygiene (HH) as a top priority to impact their high reliability organization and patient safety improvement commitment; choosing to implement an automated hand hygiene monitoring system (AHHMS). There is evidence that AHHMS must be part of a multimodal HH program, yet there remain few published studies describing detailed intervention strategies.

Methods: An AHHMS that provides group HH performance rates (100 x HH product dispenses divided by the number of room entries plus exits) was implemented concurrently in nine adult units at an urban academic medical center for 32 weeks (March - October 2022). After a 21-day baseline period the intervention period included a department leader report of hand hygiene performance rates discussed in daily safety huddles under medical center CEO direction, strong nurse leadership engagement, and AHHMS vendor provided clinician-based support and feedback. Statistical Analysis was performed by comparing Rate Ratios (RR = ((ETest/OTest) / (EBL/OBL))) from the 21-day baseline period to the first and last 21-day intervention periods on aggregate data from all nine clinical units.

Results: During the intervention period, the median HH rate increased significantly in all units (p < 0.05), ranging from 48% to 104% improvement vs. baseline. Overall, there was a significant increase in HH compliance over the baseline period at the conclusion of the first 3 weeks of the intervention period (RR = 1.09, p < 0.001) and at the end of the 32-week intervention period (RR = 1.61, p < 0.001).

Conclusions: The intervention increased overall HH and performance rates for all units. The strong medical center leadership intervention led to dramatically improved HH rates in only weeks and performance was sustained for months.