Clean hands

Region's hand-hygiene effort gains momentum

Clean hands

Winnipeg Health Region
Wave, November / December 2015

A Winnipeg Health Region initiative to increase hand-hygiene rates among health-care providers is paying off.

Data compiled by the Region show the overall hand-hygiene compliance rate in acute-care facilities has increased over the last three years, according to Myrna Dyck, the epidemiologist with the Region's Infection Prevention and Control Program.

"The positive impact to patient care is demonstrated through the improved compliance with hand hygiene that these facilities have shown over time," says Dyck.

The Region launched its effort to increase hand hygiene among health-care providers in 2013, setting a compliance rate goal of 80 per cent. Research has shown that a 20 per cent increase in hand-hygiene compliance within a hospital can lead to a drop in hospital acquired disease rates among patients.

During the last three years, the overall hand-hygiene compliance rate in acute- care settings within the Region increased to 70.4 per cent in fiscal year 2014/15, up from 59.9 per cent in 2012/13. The trend continued into the second quarter of 2015/16, with the overall compliance rate hitting 71 per cent.

The data also show that compliance rates are improving for all health-care providers. For example, the compliance rate for nurses across the Region was 73.8 per cent in 2014/15, up from 65.4 per cent in 2012/13. 

The biggest compliance rate improvement was recorded by physicians. The rate for doctors in acute-care centres across the Region was 58.1 per cent in 2014/15, up from 35.7 per cent in 2012/13. The rate for health-care assistants, meanwhile, has also improved, hitting 69.8 per cent in 2014/15, up from 58.4 per cent in 2012/13.

The goal now, says Dyck, is to maintain and build on these levels of compliance from quarter to quarter.  

As she explains, infections picked up in a health-care setting can decrease positive patient outcomes and increase their length of stay in hospital. "Hand hygiene is the single most effective way to prevent infections," says Dyck.

In launching the hand-hygiene initiative, the Region took a number of important steps. Auditors were identified and trained to appropriately, consistently, and reliably measure compliance across departments and different areas of care. Hand-hygiene education was made mandatory for health-care workers on a bi-annual basis.

Various hospitals within the Region also took a number of steps to increase staff knowledge about hand hygiene and their ongoing compliance rates, says Dyck. One such initiative is letting patients know it is okay to ask if staff have washed their hands, she says. 

Although everyone is familiar with the concept of hand washing, the standards necessary for a hospital setting are different than those required for life at home.

There are four key moments when health-care providers must clean their hands, known as the "Four Moments for Hand Hygiene." They are:

  • Before contact with a patient or the patient's environment
  • Before a clean or aseptic procedure with a patient
  • After blood or body fluid exposure risk
  • After contact with a patient or the patient's environment

Proper hand hygiene involves using hand sanitizer and rubbing it into your hands until they are completely dry, or washing your hands with soap and water for 15 seconds. Alcohol-based hand sanitizer is the first recommended option for hand hygiene, unless hands are visibly soiled.

"It's hard to put new habits into your practice, but the Region is committed to making this a priority" says Dyck. "There are many opportunities for germs to be spread across health care settings. Hand hygiene is a way to protect patients, their families, and staff - not only at work, but when they go home as well."

Holli Moncrieff is a Winnipeg writer.

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