Background: Direct observation and feedback of hand hygiene compliance is an important tool in improving hand hygiene and reducing healthcare-associated infections. Reported hand hygiene (HH) compliance in the operating room (OR) setting is historically low and provides an area for targeted improvement efforts.
Methods: In 2011, a hand hygiene program to monitor and report staff compliance was established in all inpatient and select procedure areas at the Children's Hospital of Philadelphia using the World Health Organization's 5 Moments for Hand Hygiene. Hand hygiene compliance is calculated by dividing the total number of compliant hand hygiene observations before patient contact, after patient contact, and after contact with patient surroundings by the total number of opportunities observed. Data collected during OR observations include staff role and surgical service, moments observed, date/time, and missed opportunity themes.
Review of baseline hand hygiene data in the OR in June 2011 led to the establishment of a multi-disciplinary team of OR leadership, Infection Prevention and Control and Environmental Services who met monthly to review data and plan improvement activities. Iterative improvement activities included posting signage, increasing access to HH product, providing just in time feedback, training OR coaches to partner with HH observers, evaluating the cleaning of the environment and staff education sessions.
Results: 3,680 hand hygiene observations were collected in the OR between July 2011 and December 2014; overall compliance increased from 55% to 92% during that time period (Figure 1) and have been consistently ≥85% since November 2012. The most common themes for hand hygiene misses were identified (Figure 2)
Conclusion: Hand hygiene compliance in the OR was improved and sustained using a multidisciplinary approach that included just in time feedback and regular data sharing. Support from OR leadership is necessary to successfully integrate hand hygiene observers into the OR environment and create local ownership and accountability.
E. Teszner, None
L. Farrell, None
D. Cohen, None
L. Schleelein, None
S. Coffin, None
J. S. Sammons, None