Implementing hand hygiene strategies in the operating suite

BackgroundAs the five moments of hand hygiene for the operating suite (OS) and post acute care unit (PACU) had not been defined, we were finding it difficult to communicate expectations for hand hygiene. Hand hygiene auditing was undertaken when reviewing infection control practice in our OS.Weobserved that although hand rub was accessible, understanding hand hygiene compliance was limited and inconsistent. The challenge was to feedback results to the OS and PACU teams using a consistent methodology.MethodsMonitoring hand hygiene compliance in the operating suite commenced in 2007 and was aimed at establishing a baseline and identifying areas for improvement. A hand hygiene improvement project for the OS commenced in 2009 which involved engagement of OS staff to work with infection control staff to monitor practice, provide education and implement changes. Hand profiling was used to demonstrate hand hygiene technique, monthly infection control meetings to review project achievements and regular hand hygiene auditing of the five moments were undertaken by OS staff.ResultsThis project resulted in the development of anOStool, adapted from the Hand Hygiene Australia audit tool. An education package was also developed that explained the five moments of hand hygiene, the patient environment specific to the OS, cleaning requirements between each patient and instruction on appropriate glove use, correct hand hygiene technique and hand care. Hand hygiene compliance improved from 11% in 2007 to 59% in 2011 (P < 0.001).ConclusionInfection control collaboration with OS staff was constructive and assisted in the implementation of change. Our project enabled expectations to be communicated and understood with the development of a specific tool and education package. We now have the opportunity to benchmark across our 28 operating rooms and with others.