4 Elements of Successful Hand Hygiene Education

1.    Wet hands with water.
2.    Apply soap and rub hands together.
3.    Rinse hands with water

That's all there is to hand hygiene, right?

Well, in healthcare settings, there's a little more to it than that. Healthcare workers have to know how to wash all parts of the hand, how long to wash, what type of soap to use and when to wash hands, among other details.

Renee Watson is manager of infection prevention and epidemiology at Children's Healthcare of Atlanta.This infection control process that is often perceived as basic or simple requires a comprehensive education program, according to Renee Watson, RNC, BSN, CPHQ, CIC, manager of infection prevention and epidemiology at Children's Healthcare of Atlanta. "Hand hygiene is one of those unique things in that people think of it as a no-brainer; [but] the simplest things can be made complex," she says.

By bringing hand hygiene to the forefront with a complete education program, Children's Healthcare of Atlanta increased its hand hygiene compliance rates from roughly 40 percent in 2006 to 86.8 percent by 2007 and 98.4 percent in 2012. Here, Ms. Watson shares some tips on what a healthcare organization's hand hygiene education program should include.

Hand hygiene: What healthcare workers need to know

1. Teach the impact. One of the core lessons in hand hygiene is its impact on infection prevention and patient safety, according to Ms. Watson. While most people know that hand hygiene is important, they may not understand the extent to which it affects patient care. "People aren't as aware as one might think about the importance of hand hygiene," she says. Hospital leaders need to teach staff and physicians that hand hygiene is one of the most effective ways to prevent the spread of infection.

2. Teach the technique.
Healthcare workers also need to learn the proper technique for hand hygiene. For example, Ms. Watson says people are supposed to rub their hands together for a minimum of 15 seconds when washing their hands. When she asks physicians and staff to mime rubbing their hands together to wash hands in a training session, however, they usually drop off around seven or eight seconds. Even people who think they wash their hands for the full 15 seconds typically do not meet that minimum in the training exercise, she says. Awareness of both the proper technique and one's execution of this technique is therefore critical to ensuring hand hygiene compliance and preventing infections.

Another important lesson is the difference between soap and water and alcohol sanitizers, according to Ms. Watson. Alcohol hand sanitizers are more effective at eliminating pathogens except when hands are visibly soiled, when the caregiver has blood and body fluids on their hands or when they have worked with specific organisms that require mechanical removal — for which soap and water should be used, she says.

Maintaining awareness, compliance

3. Continue education. Hand hygiene education should not end with one training session or test; it should be a continual process of learning that reminds healthcare workers of the importance of hand hygiene and maintains compliance rates. "Me and my team, we are so tired of talking about hand hygiene; we've been doing it for 15 years. But if we stop talking about it, people will forget," she says. "You have to keep moving, consistently push the envelope in your own environment."

To maintain enthusiasm and understanding of hand hygiene, Ms. Watson suggests trying new products and using different educational tools. Many governmental and private organizations offer educational resources. For example, the World Health Organization offers an infographic on the "Five Moments of Hand Hygiene," which illustrates the five occasions that require hand hygiene in healthcare settings. Children's Healthcare of Atlanta uses Kimberly-Clark's healthcare-associated infection prevention and training tools, which focus on the central role of hand hygiene.  

4. Engage front-line staff. A hand hygiene education program should also engage front-line workers so they buy in to the hand hygiene initiative and develop effective hand hygiene strategies. Ms. Watson engages physicians and staff by asking them questions and doing mini "experiments," such as the miming of washing one's hands for 15 seconds. Front-line workers also provide input on where new hand sanitizers should be located in the hospital.

Hand hygiene education is key
Hand hygiene, while seemingly simple, gains complexity in a healthcare environment. Hospital leaders need to educate workers on the importance and technique of hand hygiene and maintain compliance over time.

More Articles on Hand Hygiene:

Why Does Low Hand Hygiene Compliance Still Plague Healthcare? 4 Reasons
Hand Hygiene Should Be Patient Safety Priority: Q&A With Premier Safety Institute's Gina Pugliese

Evidence-Based Approaches to Hand Hygiene: Best Practices for Collaboration

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