November 4, 2010

Campaigns on tap to raise hand-washing compliance

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Campaigns on tap to raise hand-washing compliance

Hand hygiene compliance rates are on the rise at Vanderbilt University Medical Center but have still not reached target levels, and special campaigns have been launched to promote hygiene efforts.

The overall slogan for VUMC is “Clean hands save lives,” because the most common means of disease transmission is the hand.

Tom Talbot, M.D., MPH, chief hospital epidemiologist, said VUMC began fiscal year 2009 with a hand hygiene compliance rate of 58 percent, and that number increased to 77 percent by this past June.

“We are seeing an improvement in compliance due to many factors. A major driver has been the availability of more granular compliance data, which units can use to drive improvement as well as increase accountability for hand hygiene compliance,” he said.

Since forming observation teams in October 2009, hand hygiene surveillance has increased dramatically with more than 21,000 observations to date, and the teams were able to conduct the first observations in outpatient areas.

“A great deal of thanks is owed to the cadre of observers, who must dedicate time each month to monitor practice in various clinical units,” Talbot said. “Without the teams, we would not have the volume of data to give feedback to leaders to help drive improvement. This increase now allows us to provide individual clinical units with their own compliance data.”

The Monroe Carell Jr. Children's Hospital at Vanderbilt has launched a colorful, kid-friendly hand hygiene campaign.

Staff have been given buttons that say, “Ask me if I've washed my hands,” and pens that say, “Wash or gel your hands every time.” Reminder stickers have been placed on sinks and gel dispensers outside patient rooms.

“Our motto is: 'Every patient, every time, every entry, every exit,'” said Paul Hain, M.D., medical director of Performance Management and Improvement (PMI). “This means washing your hands every time you come into contact with a patient or their things.”

Children's Hospital first assessed hand hygiene compliance in summer 2009 at 52 percent, which was below the VUMC average. Compliance has improved to 70 percent, as measured in June 2010. The goal for all of VUMC is to be above 95 percent compliant.

About 500 compliance surveys are now done per month and “secret shoppers” are sent onto the units to covertly evaluate compliance.

“We feel we are getting real data,” said Jenny Slayton, M.S.N., R.N., administrative director of PMI. “There had been pushback that there was no way our compliance could be this bad, but our secret shoppers on the unit are realizing that our compliance is actually worse than they thought.”

PMI performed a computer survey to ask what they could do to assist with compliance and make hand hygiene an easy part of work flow. They are also sending the message that it is acceptable for people at all levels of the organization to remind others to wash their hands.

“We're asking all staff to help each other out. Until it becomes a habit, it's hard to remember to wash your hands 100 percent of the time. We're making it OK for anyone to remind anyone to wash their hands, regardless of who they are,” Slayton said.

Talbot applauds Children's Hospital for mounting this special campaign for hand hygiene.

“We are seeing ownership of hand hygiene improvement on many levels with units and groups enhancing the Medical Center program with additional initiatives, education and incentives. That's how we develop an ingrained safety culture and it's exciting to see it emerging at VUMC,” he said.

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