1009. Hand Hygiene Compliance in Alberta Health Services (AHS)
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
  • SHEA2012_HHreviews2011_FINAL_KBush.pdf (273.8 kB)
  • Background: Hand hygiene (HH) is the most effective method for preventing transmission of micro-organisms and the development of hospital-acquired infections. The literature shows that less than 50% of healthcare workers perform HH appropriately. We conducted one of the largest simultaneous multi-facility hand hygiene compliance reviews to date.

    Methods: In Summer 2011, a province-wide review of HH compliance was conducted in all Alberta Health Services (AHS) facilities to establish baseline rates of HH compliance. AHS and their partners provide health care services for a province with 3.8 million people distributed over a geographic area of 225,541 sq. mi. There are 9088 acute care beds in more than 100 facilities, ranging in size from 4 in remote communities to 1062 beds in urban centres.  Observations were done on direct care providers in an estimated 105 AHS facilities including acute, continuing, and ambulatory care. Compliance was measured using the “4 Moments for Hand Hygiene”.  Each observation was coded using standardized software on iPads. Barriers to compliance were also observed.

    Results: Nearly 28,000 observations were collected across AHS. Overall HH compliance was 50%.  Tertiary acute care sites were lowest at 36% compliance compared to suburban and rural facilities at 68% compliance. Of all the observations, physicians were the least compliant at 32% and nurses were the most compliant at 54%.  Of the “4 Moments” observed, compliance was lowest at 33% for before patient contact; higher before an aseptic technique at 41% and after patient contact at 60%; and highest after a blood/body fluid exposure at 68%. The major barriers to HH compliance were the inappropriate use of gloves and the use of gloves as a substitute for hand hygiene.

    Conclusion: This province-wide review demonstrated sub-optimal HH compliance rates across Alberta’s healthcare facilities, among all healthcare workers, and at high risk moments. These results have triggered intensive dialogue, and strategies to increase HH are being implemented to improve patient safety. An annual province-wide HH compliance review is planned to monitor outcomes of this work.

    Jenine Leal, MSc1, Janet Barclay, BScN2, Karen Hope, MSc1, Debra Doe, RN, BScN, MN3, Dan Woods, BSc, CIC4, Sue Lafferty, RN, BScN, CIC5, Elizabeth Henderson, PhD1, Kathryn Bush, MSc1, Kimberley Simmonds, MSc5,6, Karin Fluet, BScN5, Nancy Alfieri, BScN1, Leanne Dekker, RN, MN, MBA5, A. Mark Joffe, MD7 and Alberta Health Services Infection Prevention and Control , (1)Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada, (2)Infection Prevention and Control, Alberta Health Services - Edmonton Zone, Edmonton, AB, Canada, (3)Infection Prevention and Control, Alberta Health Services, Red Deer, AB, Canada, (4)Alberta Health Services, Red Deer, AB, Canada, (5)Infection Prevention and Control, Alberta Health Services, Edmonton, AB, Canada, (6)Community Health Sciences, University of Calgary, Calgary, AB, Canada, (7)University of Alberta, Edmonton, AB, Canada


    J. Leal, None

    J. Barclay, None

    K. Hope, None

    D. Doe, None

    D. Woods, None

    S. Lafferty, None

    E. Henderson, None

    K. Bush, None

    K. Simmonds, None

    K. Fluet, None

    N. Alfieri, None

    L. Dekker, None

    A. M. Joffe, None

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