311. Hand Hygiene Compliance in Alberta Health Services
Session: Poster Abstract Session: Hand Hygiene in Healthcare Settings
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • SHEA2013_HHreviews201112_Sept24_FINAL.pdf (201.7 kB)
  • Background: Extensive literature shows that Hand Hygiene (HH) is the most effective method for preventing transmission of micro-organisms and the development of hospital-acquired infections. However, less than 50% of healthcare workers (HCW’s) perform HH properly. AHS serves a population of 3.8 million people distributed over a geographic area of 225,541 sq. mi. There are 11,400 acute care beds in more than 100 hospitals, which range in size from 4 beds in remote communities to 930 beds in large cities.

    Methods: In Summers 2011 and 2012 province-wide HH compliance reviews were conducted in AHS facilities. The 2011 observations were conducted at 105 AHS facilities; this increased to 136 facilities in 2012 including acute, continuing and ambulatory care. Compliance was monitored using the Canadian Patient Safety Institute “4 Moments for Hand Hygiene”. Each observation was coded using iScrub Lite on iPads. Barriers to compliance were also recorded.

    Results: In 2011, 27,728 opportunities for HH were observed.  Results were shared widely, a variety of educational initiatives were undertaken and 63,989 HH opportunities were observed in 2012. Overall, provincial hand hygiene compliance increased from 50% to 58.4%. Of the five AHS zones, the Edmonton Zone had the greatest increase in compliance from 43.2% to 56.6%. Tertiary acute care hospitals had the greatest increase, from 35.8% to 51.1%.  Rural and non-acute care sites declined from 68.3% to 60.6%. Of the healthcare worker groups monitored, physicians demonstrated the greatest increase in compliance, from 31.6% to 42.5%. Of the 4 Moments observed, Moment 1 (before patient contact) had the greatest increase in compliance from 32.9% to 47.3% and Moment 3 (after blood/bodily fluid exposure) had the smallest increase, from 68.4% to 70.9%. The major barriers to HH compliance continued to be the inappropriate use of gloves, primarily as a substitute for HH.

    Conclusion: These very large province-wide reviews demonstrated a 17% increase in HH compliance in Alberta healthcare facilities. These results have triggered intensive dialogue and action plans to improve HH practises. A 2013 HH summer review is planned to monitor progress in hand hygiene across the province.

    Elizabeth Henderson, PhD1, Vanessa Shelley, MPP2, Jenine Leal, MSc3, Sue Lafferty, RN, BScN, CIC4, Janet Barclay, BScN5, Karen Hope, MSc6, Debra Doe, RN, BScN, MN7, Karin Fluet, BScN4, Nancy Alfieri, BScN6, Leanne Dekker, RN, MN, MBA4, A. Mark Joffe, MD8 and Alberta Health Services (AHS) Infection Prevention and Control (IPC), (1)Alberta Health Services, Calgary, AB, Canada, (2)Surveillance, Alberta Health Services, Calgary, AB, Canada, (3)Pediatrics, University of Calgary, Calgary, AB, Canada, (4)Infection Prevention and Control, Alberta Health Services, Edmonton, AB, Canada, (5)Infection Prevention and Control, Alberta Health Services - Edmonton Zone, Edmonton, AB, Canada, (6)Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada, (7)Infection Prevention and Control, Alberta Health Services, Red Deer, AB, Canada, (8)University of Alberta, Edmonton, AB, Canada


    E. Henderson, None

    V. Shelley, None

    J. Leal, None

    S. Lafferty, None

    J. Barclay, None

    K. Hope, None

    D. Doe, None

    K. Fluet, None

    N. Alfieri, None

    L. Dekker, None

    A. M. Joffe, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.