Any Ideas on Increasing Hand Washing Compliance?

[flashpoint]

I am my facility's infection control and prevention nurse. During our recent corporate survey, we got nailed for poor compliance with hand washing and use of gloves. My DON and administrator want me to come up with some ideas to increase compliance.

My first thought is simply to try to put the "fear of God" in everyone. A few years ago, a friend of mine spent over 100 days in the hospital after she got an infection when a nurse scratched her while helping her move up in bed. She ended up with a surgical debridement, a wound vac, and weeks of IV antibiotics. She has gross, ugly, and painful scars on her upper arm. She would love to tell her story to our staff.

I hate the idea of "Ask Me if I Washed My Hands" buttons. I dread the idea of scripting. I don't want to burden anyone by asking them to be a "Secret Shopper" hand washing compliance monitor. I know from experience that the people I work with would make a mockery and cheat if we did something like rewarding staff that wash their hands with candy or whatever.

I know the issue certainly isn't limited to my facility. Hand washing compliance is poor in many LTCs, hospitals, and clinics.

[Adele_Michal7, ASN, RN]

Hmmm, good question. Maybe you could try to hone in on the specific reasons people are slacking, and then implement strategies to address those items.

For example: staff not using Purell frequently enough because "it dries out my hands."

Potential solution? Provide a nice-ish quality hand lotion, have central supply order a case and keep med and treatment carts stocked with it.

[CapeCodMermaid, RN]

My lab has some powder which is invisible but reacts under black light (like the posters we had in the 1960s!). I've sprinkled it around the units then done surprise viewings with the light. People are really surprised but it works.

Sometimes the fear of God or the fear of the DON is the only thing that works.

[vintagemother, BSN, CNA, LVN, RN]

Is it possible to make hand washing more convenient by placing the sanitizer dispensers throughout the unit or ideally near all doors?

Have you considered having an optional meeting to develop a "committee" whose job is is to figure out the reasons people give for not washing hands? Then, once you know why, you can work on solving the problem.

[CapeCodMermaid, RN]

I was just in the hospital as a patient. Every room has a big sticker which reads GEL IN GEL OUT. Without fail, every provider used the gel on the way in and on the way out. I think it this case, it was fear of upper management. They knew I was a nurse so told me things they might not have told a 'regular' patient, but they were all scared to get written up for any infraction such as not documenting 1 hour rounding, making sure the bed was in the lowest position when they left the room even for a minute to get supplies. I had the feeling there was a lot of rounding by the big wigs to make sure people were doing what they were supposed to be doing. I hate to manage with fear but if that's all that works I guess you have to do what you have to do.