18 January 2018
Exploring options for reporting hand hygiene compliance in NSW health facilities
Patient safety is of paramount importance and healthcare associated infections are a key concern of healthcare systems around the world.
We know that good hand hygiene plays an essential role in minimising hospital infection rates – the most common way for potentially harmful bacteria to transfer between patients is on the hands of healthcare workers.
We also know that public reporting can help to shine a light on areas that have improved, or have room for improvement.
BHI recently had the opportunity to bring both of these factors together through working with audit data provided by the Clinical Excellence Commission (CEC) on hand hygiene compliance in NSW.
The CEC manages the National Hand Hygiene Initiative in NSW. The program, run in conjunction with Hand Hygiene Australia, provides training, education, and promotional and reporting resources in order to raise awareness of the importance of hand hygiene.
More than 200 facilities in NSW submit data to the program. Participating facilities include acute inpatient hospitals, residential aged care centres, community health networks and dental facilities and are located across the state’s local health districts (LHDs) and specialty networks.
A key part of the program is audit. Throughout the year, trained hand hygiene auditors collect data using direct observation of their colleagues’ hand cleaning practices before and after clinical encounters.
The audit focuses on the ‘five moments’ of hand hygiene as defined by the World Health Organization (WHO), which include two ‘before moments’ that occur before patients are touched and three ‘after moments’ that occur after a patient has been touched.
In consultation with CEC, BHI examined different ways to analyse and visualise the audit data. There were two objectives for this work. First, to assess whether there are simpler ways to report on hand hygiene compliance. Second, to explore the connection, if any, between hand hygiene compliance reported by the trained auditors and patient-reported experiences of observing doctors and nurses wash their hands.
We have created a chartpack to highlight the results of this collaboration with the CEC.
- Compliance reporting based on the two ‘before moments’ resulted in similar findings as current compliance reporting using all five moments.
- While there has been an increase in hand hygiene compliance rates over time, rates are starting to plateau.
- Patient survey data also show an increase over time in the percentage of patients who said they ‘always’ saw nurses and doctors wash or clean their hands before touching them. However, there was no strong correlation between compliance and survey results for public hospitals.
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Dr Diane Watson is the Chief Executive of the Bureau of Health Information. She has 20 years of senior management experience measuring, monitoring and reporting on the performance of healthcare systems in Australia and internationally.
Lisa Corscadden is a senior researcher at the Bureau of Health Information. She has experience in healthcare research in Australia and Canada, with an interest in measuring equity in healthcare.
Lilian Daly is the Lead for Strategy and Engagement at the Bureau of Health Information. She holds a Master’s degree in public health from the University of New South Wales and has extensive experience as a healthcare clinician, researcher and educator.
Hilary is our Senior Director, Communications and Strategic Relations. She has extensive experience in developing policy and strategy around the role of information in improving healthcare.
Renee Carter is a former senior analyst at the Bureau of Health Information. She holds a Masters degree in health and social policy from the London School of Economics and a Doctorate in epidemiology from McGill University.
Jean-Frederic is the former Chief Executive of BHI. He is now Chief Executive of the Agency for Clinical Innovation.
Kim is the former Senior Director, Performance Measurement & Reporting at BHI. She has extensive experience in health services research in Australia and internationally.