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BMC Infect Dis. 2013 Aug 7;13:367. doi: 10.1186/1471-2334-13-367.

Improving hand hygiene compliance in the emergency department: getting to the point.

Author information

1
Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany. sscheithauer@ukaachen.de

Abstract

BACKGROUND:

The emergency department (ED) represents an environment with a high density of invasive, and thus, infection-prone procedures. The two primary goals of this study were (1) to define the number of hand-rubs needed for an individual patient care at the ED and (2) to optimize hand hygiene (HH) compliance without increasing workload.

METHODS:

Prospective tri-phase (6-week observation phases interrupted by two 6-week interventions) before after study to determine opportunities for and compliance with HH (WHO definition). Standard operating procedures (SOPs) were optimized for invasive procedures during two predefined intervention periods (phases I and II) to improve workflow practices and thus compliance with HH.

RESULTS:

378 patient cases were evaluated with 5674 opportunities for hand rubs (HR) and 1664 HR performed. Compliance significantly increased from 21% (545/2603) to 29% (467/1607), and finally 45% (652/1464; all p<0.001) in phases 1, 2, and 3, respectively. The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs. In parallel, the number of HR performed increased from 3 to 5 for non-surgical (p<0.001) and from 2 to 3 for surgical patients (p=0.317). Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively.

CONCLUSIONS:

Our study provides the first detailed data on HH in an ED setting. Importantly, HH compliance improved significantly without increasing workload.

PMID:
23919402
PMCID:
PMC3750281
DOI:
10.1186/1471-2334-13-367
[Indexed for MEDLINE]
Free PMC Article

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