Becker's ASC Review spoke with Naomi Kuznets, PhD, vice president and senior director of the Accreditation Association for Ambulatory Health Care's Institute for Quality Improvement, about how ASCs can improve hand hygiene compliance.
Note: Responses have been lightly edited for clarity and style.
Here are the insights Dr. Kuznets shared:
Question: What are some ways ASCs can improve hand hygiene compliance?
Dr. Naomi Kuznets: First let's acknowledge that as a society we are not doing a great job regarding hand hygiene. This does not excuse healthcare workers, who have sworn an oath [to] "do no harm" and are tasked with managing and improving the health of patients, from following hand hygiene guidelines.
That being said, multiple and ongoing interventions may be most effective. These might include:
● In-service activities, [during which leaders] explain why and just how important this is, review what the guideline recommendations are and discuss misconceptions.
● Strategically placed reminders/posters reminding all those with patient (or equipment/supplies) contact about not only the importance of, but also what comprises, good hand hygiene.
● Strategically placed hand hygiene equipment (e.g., sanitizers, wipes,) based on input from healthcare providers. In other words, make it as easy as possible to follow hand hygiene guidelines, which includes getting "buy-in" from staff.
● Observation. Although providers may only follow hand hygiene recommendations when they are being observed, making observation a relatively random, unannounced activity may keep providers on their toes.
● Unannounced hand swabbing and growing cultures [to compare] "clean" hands to [hands] cleaned per hand hygiene recommendations. This may seem invasive, but this is what it may take for certain providers to understand the difference between their perceptions of “clean” versus hand hygiene guideline levels of clean.
Q. Why is hand hygiene still a problem for ASCs and other healthcare organizations?
NK: Hand hygiene is an issue for us as a society overall. Providers are rushed. They believe they have clean hands or they are not aware of the exact guideline recommendations for hand hygiene. This means:
● ASCs must emphasize that hand hygiene is important enough to take the time.
● ASCs should make sure that providers know and are reminded what the components of hand hygiene recommendations are.
Q: Once an ASC meets hand hygiene standards, how can they stay compliant in the long term?
NK: Providers come and go, or revert to their previous behavior without reinforcement. This means hand hygiene is not "one and done." ASCs need to continue to emphasize the importance with interventions such as those mentioned above.
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