Using a multimodal strategy to improve patient hand hygiene.

OBJECTIVE

The role of health care worker hand hygiene in preventing health care associated infections (HCAI) is well-established. There is less emphasis on the hand hygiene (HH) of hospitalized patients; in the context of COVID-19 mechanisms to support it are particularly important. The purpose of this study was to establish if providing patient hand wipes, and a defined protocol for encouraging their use, was effective in improving the frequency of patient HH (PHH).

DESIGN

Before and after study.

SETTIN

General Hospital, United Kingdom.

PARTICIPANTS

All adult patients admitted to 6 acute elderly care/rehabilitation hospital wards between July and October 2018.

METHODS

Baseline audit of PHH opportunities conducted over 6 weeks. Focus group with staff and survey of the public informed the development of a PHH bundle. Effect of bundle on PHH monitored by structured observation of HH opportunities over 12 weeks.

RESULTS

During baseline 303 opportunities for PHH were observed; compliance with PHH was 13.2% (40/303; 95% confidence interval 9.9-7.5). In the evaluation of PHH bundle, 526 PHH opportunities were observed with HH occurring in 58.9% (310/526); an increase of 45.7% versus baseline (95% confidence interval 39.7%-51.0%; P < .001).

CONCLUSION

Providing patients with multiwipe packs of handwipes is a simple, cost-effective approach to increasing PHH and reducing the risk of HCAI in hospital. Health care workers play an essential role in encouraging PHH.