Hand hygiene awareness: from the inside looking in

Debra Lee 1, Karen Beaumont 1, Thi Aung 1, Craig Margetts 1, Joel Dulhunty 1,2,3

Redclife Hospital MNHHS, Redcliffe, QLD, Australia

The University of Queensland, Brisbane, QLD, Australia

Queensland University of Technology, Brisbane, Queensland


Introduction: Medical officer (MO) hand hygiene (HH) compliance has historically been below the national threshold of 70% and 17-18 percentage points lower than nursing staff. Routine HH audits have an external reporting focus and do not collect results by individual, team or practitioner level. This MO hand hygiene initiative aimed to improve HH compliance by focussing on awareness and barriers to compliance at Redcliffe Hospital.

Methods: Interns were trained and rostered to audit MO HH compliance for 1 hour during a two-week period in ward, emergency department and theatre settings. Interns did not audit their own team and used a photo-board to identify individuals. The audit was conducted in 2015 and 2016. Results were presented to medical staff. Monthly compliance was monitored by routine audit.

Results: Twenty interns audited 284 moments (72 MOs) in March 2015. Overall compliance was 69%; highest compliance was observed after a procedure (74%) and for registrars/principal house officers (71%). Barriers included accessibility of hand rub (n=32) and use of gloves without hand washing (n=9). In April 2016, 22 interns audited 333 moments (94 MOs). Overall compliance was 80% with highest compliance amongst interns (94%) and after touching a patient or procedure (87%). Inaccessibility of hand rub was low (n=4); gloves were used without hand washing in 6 cases. Mean compliance in the 14 months prior to each MO audit increased from 62% to 69% (p = 0.021).
Conclusion: MO involvement in training and peer review, combined with individual/team accountability, may contribute to improved HH compliance.

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