Various ways exist to establish accountability in healthcare settings. Regardless of the method of accountability, it is essential that following hand hygiene compliance expectations becomes the work environment culture, from the leadership level to the frontline level.”— Ericka Kalp, PhD, MPH, CIC, FAPIC

when observing questionable practices. It is important to establish a‘ no-blame’ culture. This may require some additional education to be successful, but the dividends involving‘ family-centered care’ is huge. To err is human, and we all need reminders at times.”

For an issue such as hand hygiene, Kalp says,“ Various ways exist to establish accountability in healthcare settings. Regardless of the method of accountability, it is essential that following hand hygiene compliance expectations becomes the work environment culture, from the leadership level to the frontline level. Some healthcare facilities promote peer-initiated hand hygiene reminders among staff. Some facilities initiate fun competitions between units, rewarding the highest compliance unit with a reward. Programs can include patient-initiated reminders if staff members forget to wash their hands.”

Getting real about how well IPs address compliance breaches by healthcare personnel as well as address their own levels of complacency is a difficult objective in most healthcare institutions.

Woodall tells it like it is.“ Compliance theater exists on both sides,” he says.“ IPs who avoid confrontation, who let things slide, who document for optics instead of accuracy mainly will do this to keep the peace. In reality, it’ s feeding the problem. If we want others to take us seriously, we need to take ourselves seriously first. Leadership cannot demand accountability from staff if IPs won’ t demand it from themselves. Silence is not neutrality, it’ s complicity. And it’ s killing our credibility.”

Kalp says in her experience, she has“ seen IPs who are fully confident and willing to remind others when hand hygiene opportunities are missed. Other times, IPs may avoid approaching a missed hand hygiene opportunity, particularly if the missed opportunity involves a physician or another higher-ranking staff member. I think it is vital that IPs keep patient safety at the forefront of the situation. Bacteria and viruses are indiscriminate; they will reside on any hand regardless of the staff member’ s role and title. It is the IP’ s duty to respectfully address missed hand hygiene opportunities, reeducate staff, and follow up with leadership for the sake of patient safety.”

“ There should be accountability at the IP level to ensure they are fully integrated into the healthcare area that they cover,” Goss says.“ The IP is the best resource available for assisting the healthcare worker / patient care unit achieve their goals for patient safety. As long as IPs are supported by their leaders, they are going to mirror that support and work to ensure their areas have what they need to decrease and eliminate healthcare acquired infections.”

St. John says his philosophy is to always lead by example, and“ sometimes lead boldly where others have never gone before.” He

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16 • www. healthcarehygienemagazine. com • may-june 2025