Implementation of a National Hand Hygiene Campaign: Germs. Wash your Hands of Them

Background:

Hand hygiene is considered one of the most effective measures in reducing and preventing the incidence of healthcare associated infections (HAI). The Scottish Government Health Directorate (SGHD) HAI Task Force requested in 2005 that a hand hygiene campaign be implemented across NHSScotland. As such, Scotland’s hand hygiene campaign, ‘Germs. Wash your hands of them’ was officially launched in January 2007.

Objective:

Monitoring of compliance by audit in accordance with the World Health Organization's five moments for hand hygiene across NHSScotland is a key aspect of this campaign with data obtained published by Health Protection Scotland.

Methods:

An audit tool and supporting protocol were developed to ensure a standard method for data collection was adopted Scotland wide for use in acute healthcare settings.

Results:

Hand hygiene compliance across NHSScotland has increased over the audit periods. During the first three audit periods (2007-2008), compliance with hand hygiene increased from an initial level of 68% to 79% in the 2nd audit period rising further to 87% in the 3rd audit period. The audit tool was modified and compliance with hand hygiene was monitored on a quarterly basis. The level of compliance measured during the 1st quarter audit period (May 2008) was 88% (CI 87%-89%), increasing to 90% (CI 89%-91%) in the 2nd quarter audit period (August 2008). Compliance with hand hygiene was 93% (CI 92%-94%) throughout the 3rd (November 2008) and 4th quarter audit periods (January 2009). Bi-monthly monitoring of hand hygiene compliance data was introduced in March 2009 as part of a zero tolerance approach to non compliance with hand hygiene launched by the SGHD in January 2009. Compliance with opportunities for hand hygiene increased from 92% (CI 91%-93%) in the 1st bi-monthly audit period to 93% (CI 92%-94%) in the 2nd bi-monthly audit period, although this increase was not statistically significant. Hand hygiene compliance was sustained at 93% (CI 92%-94%) in the 3rd bi-monthly audit period. Furthermore, hand hygiene compliance among nurse, medical, allied health professional and ancillary staff groups has increased throughout the campaign.

Conclusions:

Hand hygiene compliance has increased significantly throughout the extent of the campaign. To support NHSScotland further we now plan to extend the campaign into non-acute healthcare settings.