Hand Hygiene is another name for hand washing or cleaning. Hands can be effectively cleaned with either soap and water, or with waterless hand sanitiser. Both are equally effective. It is an expectation that all staff at Mount Hospital frequently clean their hands.
Hand hygiene is simple and is the most important way of preventing infections in hospital. Our hands may look clean but many germs are invisible to our eyes. We can unknowingly transmit bacteria and viruses to others and our environment. Germs can survive on unwashed hands for over an hour.
People (especially children) sometimes take short-cuts when they are supposed to wash their hands – particularly when there is no dirt visible. And unfortunately, hand hygiene is sometimes not well performed by health care workers.
What is Mount Hospital doing to improve hand hygiene?
It is important that we monitor that healthcare workers are using correct hand hygiene. There is no magic way of knowing if a person has washed their hands. The accepted way of measuring hand hygiene is for a trained auditor to monitor healthcare workers as they go about their day, treating patients in hospital. There is a government-approved organisation called ‘Hand Hygiene Australia’ that helps with this auditing. Mount Hospital has a “gold-standard auditor” on site, accredited through Hand Hygiene Australia. This person is trained to check that staff are performing hand hygiene as often as they should.
Each opportunity for hand hygiene is called a “moment”. Five Moments for hand hygiene have been identified by the World Health Organisation as the critical times when hand hygiene should be performed by healthcare workers. These are:
- Before touching a patient
- Before a procedure
- After a procedure
- After touching a patient
- After touching a patient’s belongings or surroundings
At Mount Hospital we observe staff during each of these moments. The auditor records whether or not hand hygiene has been performed correctly by each staff member at each opportunity for hand hygiene. At the end of the audit, an overall score is calculated. This is shown in the graph below.
This graph shows the percentage of moments where hand hygiene was performed correctly at Mount Hospital over the past 4 years compared with the Australian benchmark of 70%.
Staff at Mount Hospital on average have a high rate of compliance with hand hygiene. The graph also shows that the hospital’s hand hygiene rate has improved over time. This suggests that our hand hygiene program is working.
The more hand hygiene moments are audited, the more reliable our figures . This figure shows how many hand hygiene moments were audited at Mount Hospital in the most recent period audited. Note that smaller hospitals are required to audit fewer ‘moments' than larger hospitals.
When audits are performed, each professional group is checked – including doctors, nurses, cleaning and other hospital staff.
The graph on the left (below) shows which groups were audited. The graph on the right (below) shows the hand hygiene rate for different staff within the hospital. The graph shows that compliance rates for nurses are higher than for other staff.
What we are doing to continue to improve hand hygiene
Common reasons identified for staff not performing hand hygiene may include:
- Hands do not appear dirty – but germs are there, even if they cannot be seen.
- Problems with skin irritation - frequent washing with soap and water can cause dryness, skin irritation or damaged skin which makes washing uncomfortable.
- Limited availability of hand sanitiser dispensers
Improvement strategies may vary from hospital to hospital. At Mount Hospital the following strategies are used:
- As the limited availability of dispensers was identified as a key concern, a major program has been undertaken to increase the number of hand sanitiser dispensers and to place them outside all patient rooms and in convenient areas throughout the hospital. This program took place in March 2012 following a national trial of hand hygiene products and dispensers. This has made hand hygiene readily accessible to staff, patients, families and visitors.
- Regular education programs are conducted for staff about healthcare associated infections and hand hygiene.
- An Infection Control Nurse to investigate issues, educate staff and carry out strategies to reduce infections.
- Monitoring the type of soap/hand sanitiser used, to minimise skin irritation
How can you help?
At Mount Hospital, patients and visitors are part of the health care team. Hand hygiene is the most important way that patients and visitors can prevent the spread of infection in hospital. Waterless hand sanitiser is just as effective as washing with soap and water. Hospital staff will appreciate a reminder from patients or relatives if they forget to wash their hands.
There are a number of things you can do to reduce the risk of infection:
- Wash your hands carefully with soap and water or use hand sanitiser upon entering and leaving the hospital.
- Wash your hands carefully with soap and water or use hand sanitiser when entering and leaving a patient’s room.
- Observe hospital signage about hand hygiene.
- If you are unable to find a hand sanitiser station, please ask staff for assistance.
For more information about how you can help: