A Hand Hygiene Education and Training Improvement Strategy in an Acute Hospital Setting

The aim of this organisational development (O.D.) project was to improve Hand Hygiene education and training compliance in an acute Hospital setting and by extension, improve hand hygiene compliance. Hand Hygiene is identified as the single most important intervention in reducing the transmission of Healthcare Associated Infections (HCAIs). In 2009, the World Health Organisation published comprehensive evidence-based guidelines on Hand Hygiene in healthcare, which introduced a standardised approach to Hand Hygiene practices; ‘The Five Moments for Hand Hygiene’. These guidelines have been adopted by the acute hospital and are core to our education and training programme. The Health Service Executive (HSE) Change model was used to guide this O.D project. Kirkpatrick's model was employed to evaluate the Hand Hygiene education and training. A pilot class completed a pre and post education, knowledge survey. It was found that 10% of attendees had not previously received hand hygiene education and training despite it being mandated. The post education assessments pointed to a modest improvement in knowledge. Pre training assessment responses showed that 17% of participants did not routinely use hand-rub. A second (knowledge and perception) survey was circulated to a stratified purposeful cohort (10%) of employees in order to assess the attitudes and perceptions of Healthcare Workers (HCWs) with regard to hand hygiene. It was found that 8% of staff had not received mandatory training and 6% did not routinely use alcohol-based hand-rub. Results show that the education and training compliance rate at the start of the project in September 2014 was 73% and this had improved to 83% by April 2015, following the education programme .The hand hygiene compliance rate was unchanged. Continued re-enforcement of this quality and patient safety indicator will remain a key deliverable for each manager through 2015.