Healthcare Hygiene magazine September 2020 September 2020 | Page 36

hand hygiene
By Paul Alper
Introducing The
5 “Rights” of Hand
Hygiene: A New
Strategic Framework for
Healthcare Organizations
Reflecting on the approach developed to help avoid drug
and medication errors -- that is the six rights of medication
administration: the right patient, right drug, right dose, right
time, right route of administration and right documentation, it
seemed to make sense that hand hygiene should also have its
own set of “rights.”
Such a framework could guide facility leadership to a fully
integrated approach comprised of essential elements necessary
to finally “get hand hygiene right.”
Thinking about what components would be needed to drive
a successful hand hygiene program, the following analogous
framework evolved, followed by some questions we might want
to ask ourselves:
Right product: Are we always choosing to use soap, sanitizer,
1 and wipes when we should?
Right dispenser/delivery system: Do we always have the
2 right dispenser strategically placed so we have access to hand
hygiene products when we need them? Is placement chosen in
accordance with the most up-to-date guidance from CMS, CDC,
Joint Commission and WHO? And for those areas we might not
have wall dispensers, do we have an appropriate personal carry
size available for staff?
Right point of care: Are we always enabling hand hygiene
3 at every point of care; are we removing obstacles that might
impede doing the right thing?
Right moment: Are we teaching the “moments” for hand
4 hygiene in a way that staff truly understands them? Are
we emphasizing all the behaviors that should trigger a hand
hygiene event including personal activities such as cell phone
and tablet use?
Right user: Are we training and motivating all the users whose
5 proper hand hygiene behavior is essential for an optimized
patient safety environment? Does this include patients, families,
and visitors, not just staff and volunteers? Are we giving staff and
volunteers actionable feedback on hand hygiene performance in
a way that motivates sustained improvement and always “doing
the right thing?”
Defining each right and adding in guidance led to the creation
of this new framework for any facility to use as a strategic guide:
Introducing the 5 “rights” of hand hygiene™:
The Right Product
Standardize on a product formulary that is backed by sound
science and developed for high frequency hand hygiene:
• Alcohol-based sanitizers
• Soaps
• Sanitizing wipes
All used with the “right” technique
The Right Delivery System
Align placement of product dispensers with CMS, CDC, Joint
Commission and WHO guidelines:
• Wall-mounted dispensers: manual and/or touch-free
• Touch-free dispensers on stands for entry and other
open areas
• Personal carry size bottles of sanitizer for use when
limited or no access to wall dispensers
• Tabletop bottles where wall mounted dispensers are
not feasible
• Sanitizing wipes in packets and canisters
The Right Point of Care
Station hand hygiene products close to where hand hygiene
moments occur:
• Outside and inside patient rooms
• Throughout the OR (acute care or ASCs)
• Nurses stations
• Treatment rooms
• Food service and prep areas
• Entry ways and lobbies
The Right Moment
Support consistent hand hygiene behavior at each moment
(indication) for hand hygiene:
• Before and after touching the patient/resident or their
surroundings
• Before and after patient care tasks
• Before and after personal activities such as eating,
handling your cell phone or device, and using the restroom
36 september 2020 • www.healthcarehygienemagazine.com