Increasing staff compliance with hand hygiene

[LMJRN]

On my unit we have been conducting hand hygiene audits for several months now. Our compliance is only approx 65% every month. We have automatic hand sanitizing gel outside every pts room, and often send out reminders to all the staff but have seen no improvement. Any ideas on how to increase nursing compliance?

[ckh23, BSN, RN]

I have seen some facilities empower the patient to ask any caregiver if they washed their hands when they come into the room. Maybe also holding an in-service reinforcing the importance of hand washing. You could also ask when you catch someone not doing it.

[tntrn, ASN, RN]

Personally, I think this is BS. After you use the hand gel outside the room, the patient is supposed to ask you if you used it? You could say yes, and nobody would be the wiser. And anyway, after you use the gel and THEN open the door, your hands are dirty anyway.

When I enter a room, before I do anything with the patient or equipment, I say this:

" let me wash my hands first...."

We cannot EVER eliminate all bacteria. And some of the bacteria that we are destroying with gels and such are actually good for us.

Common sense needs to be a factor, but rarely is.

[GHGoonette, BSN, RN]

There's a nice little thread, sadly too short, in which one of the posts suggested a slogan "spread love, not MRSA".

Maybe you need a clever little catch phrase like that to get your staff's attention :)

[General E. Speaking, RN, RN]

Our hospital has the foam on the outside of the rooms. The catchy phrase we use is: Foam in/foam out.

[RNfaster]

Offer hand sanitizers that aren't as drying. Medline's Epiclenz gel isn't drying - I love it (except it does build up on the hands requiring washing at sink --but that's fine with me as it's non-drying). I get a rash from Purell sanitizer foam after just five uses in one day.

http://www.medline.com/hand-hygiene/instant-hand-sanitizers/

[Flo., BSN, RN]

My hands and arms are wrecked from soo much washing. We really need high quality soap, foam and lotion to protect staff hands.

If it hurts to wash your hands chances are you will not do it.

[tntrn, ASN, RN]

My hands and arms are wrecked from soo much washing. We really need high quality soap, foam and lotion to protect staff hands.

If it hurts to wash your hands chances are you will not do it.

And you can't tell me that rash-y, maybe even bleeding hands are healthy. Same with nails. I know, I know, acrylics are Baaaaad, but my cuticles have never been in worse shape since I had to give them up.

[VivaLasViejas, ASN, RN]

I got my staff to improve their compliance with hand hygiene by purchasing a batch of trial-size Bath & Body Works sanitizers in different scents for them to experiment with, along with holders that can go right on belt loops, key holders, or lanyards. They were a smash hit---the gel actually makes hands softer, and the scents are simply scrumptious!---and pretty soon, voila!: fewer UTIs among the residents.

[catshowlady]

A couple of thoughts:

Try to reinforce good behavior rather than punish bad behavior. Be the "hand hygiene fairy" and hand out a little reward any time you see a staff member clean before & after pt contact. It could be a coupon for a free drink in the cafeteria, a decent pen, a little bottle of the antibacterial lotion from Bath and Body Works. I know I just roll my eyes at people who want to nit-pick every little thing I do when it is crazy busy and I'm just trying not to drown. You don't want to be the "bad guy."

As already mentioned, the products have to be comfortable to use. We use the Steris foam, and it is wonderful. No icky buildup, and not drying like soap and water. I had an assignment of 2 C Diff pts one weekend, and by Sunday night, my hands were dry, cracked, and bleeding from all the handwashing. My hospital also supplies hand lotion for the staff.

I have also found that, while I always use the foam when I left a room, using it when entering was harder to remember. Why? I often went into the room with my hands full of pills/water/IV bags/linen/whatever. If I have a spot right by the sanitizer to put the stuff down and clean my hands, then go back to whatever it was I was going to the room to do, it is easier to comply with the rules. (Just don't get me started on how I am recontaminating my hands with whatever was on the stuff I took in the second I pick it back up. It seems illogical to me, but whatever.)

:paw:

[locolorenzo22, BSN, RN]

personally, I remind pts on admit that they can always ask if we washed our hands, and empower them by saying "I'll say yes i did, but let me regel/rewash my hands for you."

A clever thing I saw once was having foam in the rooms and outside the doors. this way, I can foam once I'm in the room, and foam on my way out as I go to the hallway. remind people of the importance of reducing infection.

I also saw a slogan one time of "MRSA is a PITA."