Four nurse-led interventions helped increase hand hygiene compliance by approximately 66 percent in six months at a Chinese hospital, according to a study in the American Journal of Infection Control.
Despite multiple hand hygiene promotional efforts, hand hygiene compliance at 850-bed Hong Kong Baptist Hospital had leveled off at slightly more than 50 percent from 2009 to 2011 after rates had increased from 41 percent to 58 percent between 2007 and 2008. To overcome possible campaign fatigue, the hospital collaborated with infection control link nurses — nurses who work with infection control staff. In the second half of 2012, hospital leaders solicited ideas to improve hand hygiene from ICLNs, who then spearheaded four programs:
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1. Poster competition. ICLNs organized a hand hygiene poster competition in each ward with the idea that self-designed posters may be more effective than ready-made posters.
2. Increased handrub access. ICLNs identified 21 locations that needed alcohol-based handrubs.
3. Physician rounds. To increase hand hygiene compliance among physicians, who had the lowest compliance levels, nurses who accompany physicians on ward rounds squirted alcohol-based handrubs on physicians' hands. After a two week pilot, compliance increased from 36.9 percent to 65.1 percent. This rate further increased to 72 percent by year end.
4. Education. ICLNs educated healthcare assistants on hand hygiene and implemented a checklist for hand hygiene compliance.
These interventions and engagement of ICLNs increased overall hand hygiene compliance to 83 percent, an increase of approximately 66 percent in six months.
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