It is now time to pull back on time consuming hand hygiene observational audits and unrealistic performance indicators (targets) for hand hygiene compliance?

[Glenys Harrington]

Dear All,

It is now time to pull back on time consuming hand hygiene observational
audits and unrealistic performance indicators (targets) for hand hygiene
compliance?

Recent publications suggest it is now time to review and rethink such
programs in developing and developed countries to ensure an evidence based
approach to hand hygiene and cost effective use of infection prevention and
control resources.

HH compliance papers

Kingston L et al. Hand hygiene-related clinical trials reported since 2010:
a systematic review. Journal of Hospital Infection 92 (2016) 309-320

. “We concluded that adopting a multimodal approach to hand hygiene
improvement intervention strategies, whether guided by the WHO framework or
by another tested multimodal framework, results in moderate improvements in
hand hygiene compliance”.

Hand hygiene compliance: are we kidding ourselves? Editorial, Journal of
Hospital Infection 92 (2016) 307-308

. “It is clear that monitoring hand hygiene compliance using direct
observation is flawed and that electronic devices/methods in combination
with smaller observational audits using appropriately trained staff would
enable a better assessment….. Hence, in an era of multi-resistant
Gram-negative bacteria, it is now time to take stock and consider that we
have spent a number of years performing research on hand hygiene with little
evidence that any particular strategy works. Perhaps future research should
be focused not on campaigns to improve hand hygiene at all costs, but on
understanding when hand hygiene is most beneficial, setting reasonable,
achievable targets, and then monitoring using validated, reproducible
methods”.

Scheithauer S et al. Workload even affects hand hygiene in a highly trained
and well-staffed setting: a prospective 365/7/24 observational study.
Journal of Hospital Infection 97 (2017) 11-16

. “Calculated compliance was inversely associated with nurses’
workload. Hand-rub activities (HRA)/patient-day (PD), observer-determined
compliance and amount of disinfectant dispensed were used as surrogates for
compliance, but did not correlate with actual compliance and thus should be
used with caution”.

Regards

Glenys

Glenys Harrington

Infection Control Consultancy (ICC)

P.O. Box 6385

Melbourne

Australia, 3004

M: +61 404816434

E: infexion@ozemail.com.au

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[Michelle Bibby]

Thank you Glenys

I have just spent 6 days as a visitor in a large public hospital (sister had
a hip replacement) and observed HH once during my visits, 2 visits a day for
6 days!

It is a conversation that must be had, but where to from here?

Regards
Michelle

Michelle Bibby
Infection Prevention Australia
+61 429 071 165
Michelle@infectionprevention.com.au
http://www.infectionprevention.com.au

Glenys Harrington
observational audits and unrealistic performance indicators (targets) for
hand hygiene compliance?

Dear All,
It is now time to pull back on time consuming hand hygiene observational
audits and unrealistic performance indicators (targets) for hand hygiene
compliance?
Recent publications suggest it is now time to review and rethink such
programs in developing and developed countries to ensure an evidence based
approach to hand hygiene and cost effective use of infection prevention and
control resources.
HH compliance papers
Kingston L et al. Hand hygiene-related clinical trials reported since 2010:
a systematic review. Journal of Hospital Infection 92 (2016) 309-320
We concluded that adopting a multimodal approach to hand hygiene
improvement intervention strategies, whether guided by the WHO framework or
by another tested multimodal framework, results in moderate improvements in
hand hygiene compliance.

Hand hygiene compliance: are we kidding ourselves? Editorial, Journal of
Hospital Infection 92 (2016) 307-308
It is clear that monitoring hand hygiene compliance using direct
observation is flawed and that electronic devices/methods in combination
with smaller observational audits using appropriately trained staff would
enable a better assessment Hence, in an era of multi-resistant
Gram-negative bacteria, it is now time to take stock and consider that we
have spent a number of years performing research on hand hygiene with little
evidence that any particular strategy works. Perhaps future research should
be focused not on campaigns to improve hand hygiene at all costs, but on
understanding when hand hygiene is most beneficial, setting reasonable,
achievable targets, and then monitoring using validated, reproducible
methods.

Scheithauer S et al. Workload even affects hand hygiene in a highly trained
and well-staffed setting: a prospective 365/7/24 observational study.
Journal of Hospital Infection 97 (2017) 11-16
Calculated compliance was inversely associated with nurses
workload. Hand-rub activities (HRA)/patient-day (PD), observer-determined
compliance and amount of disinfectant dispensed were used as surrogates for
compliance, but did not correlate with actual compliance and thus should be
used with caution.

Regards
Glenys
Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is
discouraged by ACIPC. If you wish to discuss specific reference to products
or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives –
registration and login required.

Replies to this message will be directed back to the list. To create a new
message send an email to aicalist@aicalist.org.au

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aicalist-request@aicalist.org.au.

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the quotes) to listserv@aicalist.org.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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[yvonne inguz]

I agree that stratergies for compliance need to improve and that auditing
may not be effective. Having observed and intercepted frequent episodes of
non hand hygiene compliance prior to invasive procedures whilst supporting
a patient at high risk of HAI over the last 4 weeks I am quite frankly
dismayed.
Yvonne Inguz
Clinical Nurse Midwife
Tennant Creek Hospital NT
08 8962 4399

On 24/08/2017 8:12 AM, “Michelle Bibby”
wrote:

> Thank you Glenys
>
> I have just spent 6 days as a visitor in a large public hospital (sister
> had a hip replacement) and observed HH once during my visits, 2 visits a
> day for 6 days!
>
> It is a conversation that must be had, but where to from here?
>
> Regards
> Michelle
>
> Michelle Bibby
> Infection Prevention Australia
> +61 429 071 165
> Michelle@infectionprevention.com.au
> http://www.infectionprevention.com.au
>
>
>
> From: ACIPC Infexion Connexion on behalf of
> Glenys Harrington
> Reply-To: ACIPC Infexion Connexion
> Date: Wednesday, 23 August 2017 at 5:14 pm
> To:
> Subject: It is now time to pull back on time consuming hand hygiene
> observational audits and unrealistic performance indicators (targets) for
> hand hygiene compliance?
>
> Dear All,
>
>
>
> It is now time to pull back on time consuming hand hygiene observational
> audits and unrealistic performance indicators (targets) for hand hygiene
> compliance?
>
>
>
> Recent publications suggest it is now time to review and rethink such
> programs in developing and developed countries to ensure an evidence based
> approach to hand hygiene and cost effective use of infection prevention and
> control resources.
>
>
>
> *HH compliance papers*
>
>
>
> *Kingston L et al. Hand hygiene-related clinical trials reported since
> 2010: a systematic review. * *Journal of Hospital Infection 92 (2016)
> 309-320*
>
>
>
> We concluded that adopting a multimodal approach to hand
> hygiene improvement intervention strategies, whether guided by the WHO
> framework or by another tested multimodal framework, results in moderate
> improvements in hand hygiene compliance.
>
>
>
> *Hand hygiene compliance: are we kidding ourselves? Editorial, Journal of
> Hospital Infection 92 (2016) 307-308 *
>
>
>
> It is clear that monitoring hand hygiene compliance using
> direct observation is flawed and that electronic devices/methods in
> combination with smaller observational audits using appropriately trained
> staff would enable a better assessment Hence, in an era of
> multi-resistant Gram-negative bacteria, it is now time to take stock and
> consider that we have spent a number of years performing research on hand
> hygiene with little evidence that any particular strategy works. Perhaps
> future research should be focused not on campaigns to improve hand hygiene
> at all costs, but on understanding when hand hygiene is most beneficial,
> setting reasonable, achievable targets, and then monitoring using
> validated, reproducible methods.
>
>
>
> *Scheithauer S et al. Workload even affects hand hygiene in a highly
> trained and well-staffed setting: a prospective 365/7/24 observational
> study. Journal of Hospital Infection 97 (2017) 11-16*
>
>
>
> Calculated compliance was inversely associated with nurses
> workload. Hand-rub activities (HRA)/patient-day (PD), observer-determined
> compliance and amount of disinfectant dispensed were used as surrogates for
> compliance, but did not correlate with actual compliance and thus should be
> used with caution.
>
>
>
> Regards
>
>
>
> Glenys
>
>
>
> Glenys Harrington
>
> Infection Control Consultancy (ICC)
>
> P.O. Box 6385
>
> Melbourne
>
> Australia, 3004
>
> M: +61 404816434
>
> E: infexion@ozemail.com.au
>
> *[image: Description: ICC Diagram ICCversion]*
>
>
>
>
>
>
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au.
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au.
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au
>

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

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