Have Your Hand Hygiene Improvements Hit a Plateau?

The global push for better hand hygiene over the past couple years has succeeded in boosting the rates of hand-washing among U.S. healthcare workers, research shows, but these improvements tend to plateau before reaching the desired compliance levels.

In other words, although hand hygiene awareness and education campaigns are working, reinforcement is needed to achieve even better results.

The results of the study, presented in a poster at the APIC Conference in Baltimore last month, are based on data submitted by 182 intensive care units and 616 non-ICUs to McGuckin Methods International's hand hygiene database. McGuckin is a patient safety organization based in Ardmore, Pa., that provides hand hygiene compliance education and measurement.

Researchers from the organization analyzed patient census data and soap and sanitizer consumption data to calculate the number of hand hygiene events occurring at the unit level. They split units into 2 groups: those reporting data before (2004 to mid-2009) and those reporting after (mid-2009 to end-2010) new Joint Commission and World Health Organization hand hygiene guidelines were released in 2009.

In both the pre- and post-guidelines groups, hand hygiene levels rose over a 12-month measurement period, but they rose significantly higher at units reporting after the 2009 guidelines were released. Hand hygiene rates climbed in the ICUs from 26 HH events per patient bed day (pbd) to 59.4 HH/pbd, and in the non-ICUs from 25.4 to 43.4 HH/pbd in the 12 months after the guidelines were released.

However, breaking down the data month by month, the researchers found that compliance levels peaked after about 6 months, then plateaued in the final months of measurement at "levels lower than recommended for effective compliance."

Hand hygiene is "performed more frequently now than prior to the release of JC & WHO guidelines," conclude the researchers. They recommends that you "maintain the momentum of higher HH frequency and avoid plateaus at your facility by incorporating education and training programs that reinforce the guidelines" after the initial push.

Irene Tsikitas