It's not enough to let your staff know you're watching their hand hygiene practices, a Long Island hospital has found. You've got to cheer them on, too.
In June 2008, North Shore University Hospital in Manhasset, N.Y., installed cameras to observe staff activity at scrub sinks and hand sanitizer dispensers in its 17-bed ICU. It also put electronic sensors in patient room doorways to track staff's comings and goings, and let staff members know that their practices were being observed.
Sixteen weeks later, video auditors reported that only 6.5% of the department's staff washed or sanitized their hands within 10 seconds of entering or leaving a patient room, according to a study published in the Jan. 1 issue of the journal Clinical Infectious Diseases.
Next, the hospital offered some live feedback. It installed an electronic message board in the ICU's hallway that announced compliance rates and displayed messages of congratulations or encouragement depending on the most recent numbers. After 16 more weeks, 81.6% of staff performed hand hygiene within 10 seconds of patient exposure. What's more, for the next 18 months the compliance rate averaged 87.9%.
"This changed the culture," says Bruce F. Farber, MD, the hospital's chief of infectious disease and the study's lead author. "It's now three years later, and people are washing their hands at dramatically higher rates."
David Bernard
