hand hygiene
By Paul Alper
The 6 Essential Elements of Hand Hygiene™ : A Refined Strategic Framework for Healthcare Organizations
Every patient , family member , visitor , staff member and volunteer who enters a healthcare facility , especially during this global pandemic , has the right to expect the highest standards for patient safety and quality .”
About a year ago we introduced a strategic framework , The 6 Essential Elements of Hand Hygiene™ , to help make hand hygiene second nature for all . Over the past year , we have refined as well as enhanced this approach and are excited to share the results this month .
Every patient , family member , visitor , staff member and volunteer who enters a healthcare facility , especially during this global pandemic , has the right to expect the highest standards for patient safety and quality . One of the most fundamental ways to achieve these standards is to create and value a culture in which hand hygiene is second nature for everyone .
Given that compliance rates , when measured accurately and reliably typically fall below 50 percent , a sound and evidence based strategic framework is essential to drive sustained improvement . Such an approach can provide a checklist of hand hygiene program elements that all work synergistically to ensure optimized hand hygiene behavior .
To that end , we have updated our framework . See the accompanying graphic and feel free to reproduce it for your infection prevention , epidemiology , patient safety and quality leadership team to use as a guide when thinking about your organization ’ s strategic approach to hand hygiene .
They six essential elements are :
➊ Advanced products
➋ Reliable delivery systems
➌ Point-of-care access
➍ Effective learning systems
➎ Safety culture
➏ Actionable feedback
Here is guidance for how to optimize each element within your organization :
Advanced Products : Select a standardized product formulary that is supported by sound science and developed for high frequency hand hygiene ; ensure that staff acceptance is widespread before implementing :
• Alcohol-based hand sanitizers
• Soaps ( plain and / or antibacterial )
• Alcohol-based sanitizing wipes
Reliable Delivery Systems : Align placement of product dispensers with CMS , CDC , Joint Commission and WHO guidelines :
• Wall-mounted hand sanitizer dispensers : manual and / or touch-free inside and outside of patient rooms ; soap dispensers at all sinks
• Consider lotion dispensers adjacent to sinks to best maintain skin health ( lotions should be latex / nitrile plus CHG compatible )
• Touch-free hand sanitizer dispensers on stands for entry ways and other open areas ; place easy-to-read signs on top to encourage use
• Personal carry size hand sanitizer bottles
• Tabletop pump bottles with soap and / or sanitizer as appropriate where access to wall mounted dispensers is limited
• Alcohol based sanitizing wipes in packets and canisters
Point-of-Care Access : Position hand hygiene products close to where hand hygiene moments occur :
• Outside and inside patient rooms
• At the bedside
• Throughout the operating room ( for acute-care facilities and ambulatory surgery centers )
• At nurses ’ stations
• In treatment and examination rooms
• In food service , dining and food-preparation areas
• At information , reception and gift shop desks and counters
• In entryways and lobbies
• Provide personal carry size for when access to wall mounted dispensers is limited or inconvenient
Effective Learning Systems : Provide targeted education and training tools ( based on behavioral science , human factors and high reliability organizational design ) to make hand hygiene best practices second nature for all :
• Organizational leadership
• Staff and volunteers
• Patients , families and visitors
Ensure tools emphasize proper technique at every moment :
• Before and after touching the patient and / or their surroundings
• Before and after patient care tasks ( i . e ., changing dressings , inserting new lines etc .)
• Before and after personal activities such as eating , handling a cell phone or device and using the restroom
Deploy facility wide reminders ( rotate them regularly to keep the motivation fresh ):
• Posters
• Elevator wraps