Orlando Health, Orlando, FL
Hand Hygiene Compliance at Orlando Health

Abstract

Background: Proper hand hygiene can help reduce healthcare-acquired infections (HAIs). HAIs prolong hospital stay, increase the resistance of microorganisms to antimicrobials, and result in additional financial burden and excess deaths. The director of Infection Prevention and Control at Orlando Health showed that only 72% of individuals entering a Clostridium difficile isolation room wore gowns, and only 45% of them washed their hands after exiting the room. These startling numbers made the need improve the overall hand hygiene compliance rate self-evident.

Methods: We performed a baseline analysis of hand hygiene among internal medicine physicians and residents. We developed succinct PowerPoint presentations lasting no longer than 5 minutes to teach about hand hygiene importance and techniques that we administered to residents in the internal medicine residency program. We then reevaluated hand hygiene compliance within the internal medicine program, including attending physicians, residents, and medical students.

Results: Baseline results showed that 80% of hand-washing opportunities were missed; attending physicians performed proper hand hygiene 8% of the time, and residents (interns and seniors) performed proper hand hygiene 12% of the time. Postintervention, the enter room/exit room hand-washing rates improved: internal medicine attending physicians, 81%/100%; seniors, 93%/100%; interns, 100%/100%; medical students, 100%/100%; and fellows, 88%/83%. Compliance among PGY 2–3 residents (seniors) showed improvement compared to their 4% rate reported in the baseline analysis.

Conclusion: Hand hygiene is the single most effective measure to prevent HAIs. Our study revealed that compliance improved after education with succinct PowerPoint presentations to promote awareness and hand-washing demonstrations. Although compliance has improved, the patient must be included in the practice to optimize safety.