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250 Improving Compliance And Standardising Hand Hygiene (HH) Practice In The Ambulatory Dialysis Setting in Singapore

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Chor Guek Chua , The New National Kidney Foundation, Singapore, Singapore
Rowena S.L Yeo , The New National Kidney Foundation, Singapore, Singapore
Y.Y Ho , The New National Kidney Foundation, Singapore, Singapore
Lily Cheng , The New National Kidney Foundation, Singapore, Singapore
Alice Tang , The New National Kidney Foundation, Singapore, Singapore
Y.M Tang , The New National Kidney Foundation, Singapore, Singapore
M.C Teo , The New National Kidney Foundation, Singapore, Singapore
Penny B.N Seet , The New National Kidney Foundation, Singapore, Singapore
Helen Goh , MINISTRY OF HEALTH, Singapore, Singapore
Background: Poor compliance and inconsistent practice of hand hygiene was observed in our Dialysis Centres (DCs).

Objective: To develop appropriate process measures as key to influence change leading to increase HH consistency and compliance through education and audits amongst Health Care Workers (HCWs) in the ambulatory DCs setting.

Methods: From November to December 2007, the Infection Control Nurse (ICN) conducted direct observation rounds to determine HH compliance. The Nursing Infection Control Task Group (NICTG) was formed in January 2008, primarily to look at the processes for improvement in IC practices using developed audit tools and visual aids. Audits were conducted from January to June 2009, across 24 dialysis centres.

Results: The multi-steps process for proper HH was standardised and implemented. HH compliance increased from 22% to 94%. Visual aids such as posters and videos on HH techniques and HH paraphernalia were visibly accessible in all DCs. Policy and procedure on HH was developed and implemented. Role models - IC champions representing the 24 dialysis centres were identified to lead and conduct peer audit within and across 24 DCs

Conclusions: The key lesson learnt include the standardisation of HH techniques across 24 DCs brings about improvement of HH compliance. However collaborative efforts are required to embrace change and promote patient safety in the DCs.