Hamilton Health Sciences Centre Healthy Hands campaign
The Healthy Hands campaign/program entered by the Hamilton Health Sciences Centre (HHSC) for the Stop! Clean Your Hands Day What’s Your Hand in It? competition was truly a team effort. The poster campaign is the brainchild of the HHSC McMaster Children`s Hospital Nursing Council for Pediatric Critical Care Unit (PCCU).
“The campaign was unique in that it was not a top-down approach to hand hygiene,” says Cindy O’Neill, Manager, Infection Prevention and Control. “The staff came up with the idea, took the ball and rolled with it. It was unique to the individual and what motivates them. As a result, we are seeing a cultural shift with improved teamwork where everyone is excited about the program.”
The Healthy Hands campaign/program for staff and families was created to increase awareness and hand hygiene rates on the PCCU. This program provides families an opportunity to participate in their child’s care and empowers them to discuss and encourage hand hygiene with the healthcare team.
A personalized poster (pictures of children of the PCCU staff taken by HHSC in-house photographers, with the message to "please wash your hands" and the reasons why) is included in each patient’s admission package. The admitting nurse writes the patient’s first name on the poster which is then displayed at the head of the bed/crib or a highly visible area for all hospital staff to view. In addition, there is large collage (approximately 8 x 5 feet) of hand hygiene poster photos (which portrays children of PPCU staff) that hangs above the parent/visitor area to promote good hand hygiene practices; and another poster with the children’s photos and the message “thank you for washing your hands” in every room above the sink.
Education is provided to every admitted patient and their family. “Family members are encouraged to use the personalized poster as a resource to remind staff to clean their hands,” says Cheryl Munroe, Registered Nurse. “The program has expanded into the community as a number of families have taken their poster home to display outside their child’s bedroom as a reminder to Home Care providers to clean their hands prior to administering care.”
To increase understanding of the 4 Hand Hygiene Moments, the Infection Control Practitioner dedicated time with each nurse to conduct one-on-one observational audits using an electronic tool to highlight common missed hand hygiene opportunities. This understanding further authorized and promoted a “gatekeeper model” to enhance good hand hygiene and support a patient safety culture.
“We did a lot of education around use of the audit tool and how staff should audit their peers,” says Connie Gittens Webber, Infection Control Practitioner. “That helped to provide a comfort level and understanding by the staff as to what was required.”
Within six months of implementation, hand hygiene rates increased by 42 per cent for Moment 1 (before Patient/Patient environment contact); and by 47 per cent for Moment 4 (after Patient/Patient environment). The unit has sustained rates of more than 85 per cent for Moment 1 and Moment 2 since the program was initiated in March 2012.
Positive feedback from the “Quality Counts” postcard (patient satisfaction survey) have also improved, particularly related to the question, "Have you been informed about the importance of Hand Hygiene.” “Families are part of our team and we involve them in what we do,” says Barb Jennings, Manager. “Asking families for feedback on how well we educated them on hand hygiene helps to build on our partnership with families.”
“The program has helped to break down the traditional silos that you encounter in large organizations,” adds Barb Jennings. “Everyone is involved and everyone is engaged. The Healthy Hands program certainly has legs and although it started in the PCCU, other units are now working together to introduce the program.” A SharePoint site has been set-up to compile unique ideas and measurement data that other units can utilize to promote hand hygiene.
“Implementing a program such as this is a long process, but so worth the effort,” says Cindy Rogers, Hand Hygiene co-ordinator. “Being recognized for our work in hand hygiene speaks volumes and we look forward to spreading our program across the country.”