If Hands Could Talk – Improving Hand Hygiene Compliance in Community Settings

Mrs Trish Horne1

1Tasmanian Health Service – North West Region, Primary Health Services, Australia


Based on evidence and recommendations from the World Health Organisation and Hand Hygiene Australia (HHA) the following components make up an effective multimodal Hand Hygiene (HH) strategy: system change, education and training, evaluation and feedback, reminders in the workplace and organisational support for healthcare workers.


Unit based education targeting barriers to change were presented to assist in achieving long-lasting improvements in hand hygiene behaviour. Introduction to hand hygiene initially included activities such as poster and HH slogan competitions, puzzles, HH product application, scenarios, and general discussion to include staff perspective of change. As knowledge to HH increased observational hand hygiene auditing was introduced.


Initial hand hygiene survey indicated that Community Services Staff where aware that hand hygiene was a cornerstone of infection prevention and control practice however there were obvious barriers to hand hygiene compliance including HH products not being available at the point of care and limited understanding of the 5 moments of hand hygiene.


  • Observational auditing of the 5 moments of HH commenced in 2013 and are conducted twice yearly results show an increase in hand hygiene compliance within the Community Services Healthcare Settings.
  • Client survey that was completed in 2016 support compliance to hand hygiene practices within this setting.


Follow up evaluation has shown successful and sustained HH improvements in the community environment. Improvements have been achieved by implementing multiple actions to tackle the different obstacles and physical barriers encountered within the community setting.


My role of Infection Prevention and Control Clinical Nurse Consultant within Primary Health was developed in 2013. This portfolio encompasses a vast array of services including Community Health Nursing, Podiatry, Aged Care Facilities, Personal Carers and Clinical Nurse Specialists.  The increasing challenges that healthcare associated infections are placing on our health care system encourages me to be innovative in quality improvement activities  in an effort to increase staff and client awareness and knowledge to the principles of standard precautions especially hand hygiene and aseptic technique.


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