Hand Hygiene is another name for hand washing or cleaning. Hands can be effectively cleaned with either soap and water, or with waterless hand sanitiser. Both are equally effective. It is an expectation that all staff at Darwin Private Hospital frequently clean their hands.
Hand hygiene is simple and is the most important way of preventing infections in hospital. Our hands may look clean but many germs are invisible to our eyes. We can unknowingly transmit bacteria and viruses to others and our environment. Germs can survive on unwashed hands for over an hour.
People (especially children) sometimes take short-cuts when they are supposed to wash their hands – particularly when there is no dirt visible. And unfortunately, hand hygiene is sometimes not well performed by health care workers.
What is Darwin Private Hospital doing to improve hand hygiene?
It is important that we check whether healthcare workers are using correct hand hygiene. There is no magic way of knowing if a person has washed their hands. The accepted way of measuring hand hygiene is for a trained auditor to watch healthcare workers as they go about their day, treating patients in hospital. There is a government-approved organisation called ‘Hand Hygiene Australia’ that helps with this measurement. Darwin Private Hospital has a “gold-standard auditor “ on site, accredited through Hand Hygiene Australia. This person is trained to check that staff are washing their hands as often as they should.
Each opportunity for hand hygiene is called a “moment”. Five Moments for hand hygiene have been identified by the World Health Organisation as the critical times when hand hygiene should be performed in hospital. These are:
- Before touching a patient
- Before a procedure
- After a procedure
- After touching a patient
- After touching a patient’s belongings or surroundings
At Darwin Private Hospital we watch staff during each of these moments. The auditor records whether or not hand hygiene has been performed correctly by each staff member at each “moment”. At the end of the audit, an overall score is calculated. This is shown in the graph below.
This graph shows the percentage of moments where hand hygiene was performed correctly at Darwin Private Hospital for the past 4 years compared with the Australian national benchmark of 70%. Staff at Darwin Private Hospital on average have a high rate of compliance with hand hygiene. This suggests that our hand hygiene program is working.
For 5 years, Darwin Private Hospital has a an experienced Infection Control Coordinator who conducted all hand hygiene audits. In early 2014, a newly trained staff member conducted their first hand hygiene audit having recently trained with Hand Hygiene Australia. The process was understandabley difficult to follow, which explains the inconsistency in hand hygiene results from period to period. Further training and guidance has since resulted in improving auditing skills, which is also refected in Darwin Private Hospital's more accurate results.
The more hand hygiene moments are audited, the more reliable our figures. This figure shows how many hand hygiene moments were audited at Darwin Private Hospital in the most recent period audited. Note that smaller hospitals are required to audit fewer ‘moments’ than larger hospitals.
When audits are performed, each professional group is checked – including doctors, nurses, cleaning and other hospital staff.
The graph on the left (below) shows which groups were audited. The graph on the right (below) shows the hand hygiene rate for different staff within the hospital. The graph shows that compliance rates for nurses are higher than for other staff.
What we are doing to further reduce infections
The reasons for staff not performing hand hygiene may include:
- Time pressure - there just is not enough time to wash hands as often as necessary.
- Hands do not appear dirty – but germs are there, even if they cannot be seen.
- Problems with skin irritation - frequent washing with soap and water can cause dryness, skin irritation or damaged skin which makes washing uncomfortable.
Improvement strategies may vary from hospital to hospital. At Darwin Private Hospital the following strategies are used:
- Conducting regular education programs for staff about infections and hand hygiene.
• An Infection Control Nurse to investigate issues, educate staff and carry out strategies to reduce infections.
- Placement of hand sanitiser dispensers in convenient areas throughout the hospital, including hallways and patient rooms. This makes hand hygiene readily accessible to staff, patients, families and visitors.
- Monitoring the type of soap/hand sanitiser used, to minimise skin irritation.
- In some areas - use of specially designed washbasins where water can be turned on and off without touching the tap.
How can you help?
At Darwin Private Hospital, patients and visitors are part of the health care team. Hand hygiene is the most important way that patients and visitors can prevent the spread of infection in hospital. Waterless hand sanitiser is just as effective as washing with soap and water. Hospital staff will appreciate a reminder from patients or relatives if they forget to wash their hands.
There are a number of things you can do to reduce the risk of infection:
- Wash your hands carefully with soap and water or use hand sanitiser upon entering and leaving the hospital.
- Wash your hands carefully with soap and water or use hand sanitiser when entering and leaving a patient’s room.
- Observe hospital signage about hand hygiene.
- If you are unable to find a hand sanitiser station, please ask staff for assistance.
For more information about how you can help: