More hospital staff keeping their hands clean to protect patients

Professor Clifford Hughes, Chief Executive Officer and his co-authors of the Clinical Excellence Commission, and A/Professor Mary-Louise McLaws, Director of Public Health Programs at the University of New South Wales, report on a campaign to increase awareness of the importance of hand hygiene in hospitals, to make AHR widely available at the point of care, and to improve rates of compliance with hand hygiene practices.

AHR was introduced into all NSW public hospitals in 2006 as part of the Clean Hands Save Lives campaign. Staff champions and project leaders were appointed to help implement a hand hygiene culture change, and collateral marketing materials (such as posters and T-shirts) were used to reinforce the campaign messages.

The campaign was conducted between February 2006 and February 2007. Although the overall level of hand hygiene increased, improvement was not uniform among all categories of staff and was not always sustained.

For example, the proportion of nursing staff who cleaned their hands after patient contact rose from 65 per cent before the campaign to an average of 74 per cent in February 2007 and July 2008.

The proportion of doctors who cleaned their hands after patient contact climbed from 34 per cent before the campaign to 63 per cent in November 2006 but declined thereafter to 55 per cent in February 2007 and 44% in July 2008.

Rates of compliance by allied health staff rose from 50 per cent before the campaign to 70 per cent in February 2007, before falling to 55 per cent in July 2008.

Some staff remained resistant to the idea of changing their hand-washing habits.

“Hand hygiene behaviour is strongly influenced by perceptions of peer group behaviour. Because nursing staff witness and respond to behaviour by doctors, a focus on doctors will increase hand hygiene compliance by both nurses and doctors,” Professor Hughes said.

“There has been a focus on nursing staff to identify their barriers to hand hygiene and AHR has certainly addressed some of the important ones. We now need two new strategies, one to empowering nursing staff who can lead now by example and the second strategy would be to focus on identifying key barriers to good hand hygiene in the medical staff”.  A/Professor McLaws said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

^{The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.}

CONTACT:   
Mr Mike Peterson 0434 308 924
Media Officer, Clinical Excellence Commission