Exploring options for reporting hand hygiene compliance in NSW health facilities

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.

The World Health Organisation 5 months of hand hygiene are: 1.Before moment – before touching a patient;2.	Before moment - before clean or aseptic procedure;3.	After moment - after body fluid exposure;4.	After moment - after touching a patient;
5.	After moment - after touching a patient’s surroundings.

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.

Key findings

  1. Compliance reporting based on the two ‘before moments’ resulted in similar findings as current compliance reporting using all five moments.
  2. While there has been an increase in hand hygiene compliance rates over time, rates are starting to plateau.
  3. 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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Page updated: 17 Jan 2018
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