Influencing change- An inside job

Julie Rieck 1, Benjamin Wakeling 1

Wollongong Hospital -Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia


Precipitating change within a department can be challenging and its success is reliant upon both internal and external factors. One important internal factor within any healthcare facility is staff. Our colleagues have the ability to greatly influence patient safety through their clinical practice.
Effective hand hygiene is vital to protect patients from healthcare associated infections. In 2014 hand hygiene auditing within the Emergency Department (ED) of a 500 bed hospital in NSW revealed compliance levels as low as 24%. This presentation describes the results of a hand hygiene improvement strategy that was led by ED staff and supported by the infection prevention and control team.

Initial improvement measures included education from the infection control clinical nurse consultant (CNC), audits to ensure appropriate product accessibility, further recruitment of auditors, improvement action plans, regular updates of compliance rates and disciplinary warnings for non-compliant staff. Progress was slow until key staff members from within the department initiated an awareness campaign which consisted of informal education, a survey about hand hygiene knowledge, loudspeaker announcements throughout the department and hand drawn posters and signage.

By the end of the auditing cycle in March 2016 hand hygiene compliance rates had progressively improved from 24% to 70.9%.Results from the staff survey indicated sound knowledge of hand hygiene inferring compliance was the main concern.

Staff ownership is a crucial internal factor to consider when endeavouring to effect behaviour change to improve patient safety within a department.

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