I had the opportunity to speak with a number of IPs at APIC. One of the topics that routinely came up was hand hygiene. During the poster session, I spoke with Brenda Grant from Stamford Hospital, who was presenting on the hand hygiene initiative at her hospital. By using a multi-faceted approach that included patient and health worker education and independent monitors, Stamford was able to achieve a higher hand hygiene compliance rate than when compliance was enforced by infection control staff alone. However, a challenge she and many other IPs face is to correlate compliance to reduction in HAIs.
I also had a lively discussion with Paula Ghazarian from Via Christi Hospital-Wichita on a different aspect of the issue. One of Paula's concerns is the definition of "hand hygiene opportunity." It's catchy to say "foam in, foam out," which implies that hand hygiene should be done every time someone enters and exits a patient room. Everyone thought this approach would improve compliance, but healthcare workers who are going from room to room replenishing supplies or delivering meals are challenged to comply with it. For example, healthcare workers who are taking contaminated equipment from the patient's room to the soiled utility room (while still wearing their soiled gloves) point out that they cannot complete hand hygiene until they have dropped off the equipment. As a result, people start to make exceptions - which are logical, but which have the effect of undermining the message.
What's the hand hygiene challenge at your hospital?