Using a multi-modal strategy to improve patient hand hygiene.

Loveday, H P; Tingle, A; Wilson, J A

OBJECTIVE The role of healthcare worker hand hygiene in preventing healthcare associated infections (HCAI) is well established. There is less emphasis on the hand hygiene of hospitalised 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 hand hygiene (PHH). DESIGN Before and after study SETTING: General Hospital, United Kingdom. PARTICIPANTS All adult patients admitted to six 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%CI 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% vs. baseline (95%CI 39.7-51.0%; p<0.001). CONCLUSION Providing patients with multi-wipe packs of handwipes is a simple, cost-effective approach to increasing patient hand hygiene and reducing the risk of HCAI in hospital. Healthcare workers play an essential role in encouraging PHH.