Hand hygiene a hot topic in 2007
Wednesday December 19, 2007 -- Jason Thompson
A quick scan of the HIROC News headlines in the past 12 months reveals hand hygiene generated a lot of discussion in 2007.

From nation-wide campaigns to a doctor in Toronto using gift certificates to encourage staff to keep their hands clean, the impact of hand hygiene goes beyond news stories — it is an issue that has permeated nearly every facet of a healthcare organization.

And why shouldn’t it? According to a report by Health Canada, healthcare associated infections (HCAI) kill between 8,000 and 12,000 people every year in this country.

A report published by the Joint Commission Journal on Quality and Patient Safety states that Healthcare workers’ compliance with hand hygiene is considered to be less than 40 per cent on average

Yet the Canadian Patient Safety Institute says hand hygiene remains the primary measure to reduce HCAIs and the spread of antimicrobial resistance.

Stories about hand hygiene began to crop up in March, with the launch of a campaign called Just Clean Your Hands — a provincial initiative being piloted at 10 organizations, one of which was HIROC subscriber Lake of the Woods District Hospital in Kenora.

The pilot involves installing hand sanitizer dispensers at every patient’s bedside, baseline surveys for healthcare workers to complete on hand hygiene, as well as focus groups for physicians and healthcare workers.

The results from the pilot will be evaluated by the Ministry of Health and Long-Term Care to determine which components are suitable to be included in a province-wide program.

In April, the first of three stories about Baycrest switching from soap and water to a foam hand sanitizer were published on the HIROC News site. Baycrest is an academic health sciences centre, hospital and long-term care home in Toronto and a HIROC subscriber.

“People could see the difference,” Chingiz Amirov, the director of infection prevention and control at Baycrest told HIROC News in April. “That’s why we hope they’ll be using it more frequently.”

The Baycrest hand hygiene trilogy concluded with a pair of articles chronicling Baycrest’s attempts to measure hand hygiene compliance by installing counters inside its dispensers, which will calculate the number of times per day each is used.

Using a student volunteer to track how often dispensers are being used by staff, Amirov’s goal is to marry the data from the counters with the data collected by the student volunteer to come up with a metric for measuring hand hygiene compliance.

This metric could be useful in other organizations so long as they have the dispensers installed.

The Canadian Patient Safety Institute was in the news in June promoting a national hand hygiene campaign called STOP! Clean Your Hands and asking healthcare organizations to take part in a pilot project.

The pilot was designed to evaluate and gather feedback on the campaign’s toolkits leading up to the official launch in October.

“We know that only a multi-modal strategy will change behaviour,” says Dr. Susan Brien, CPSI’s director of operations for Quebec, Atlantic Canada and Nunavut. “In addition to providing campaign tools, CPSI is also offering supports to help organizations sustain their efforts.

This includes a web-based educational module which will be posted on the campaign’s website along with an adaptation of World Health Organization tools designed to encourage campaign participation within individual organizations.

“We will also be partnering with the Ministry of Health and Long-Term Care in Ontario to facilitate train the trainer sessions that will help hospitals learn how to measure hand-hygiene,” Brien told HIROC News in October.

There was some hand hygiene controversy in the news as a doctor at the University Health Network (UHN) introduced a campaign to reward staff with a $2 Tim Hortons gift certificate if they’re caught cleaning their hands.

Dr. Michael Gardam, director of infection prevention and control at UHN, told HIROC News he was prepared for, and received, a lot of polarizing feedback about his plan.

While some people say they recognize the value of getting healthcare workers to wash their hands, even if it involves token rewards, others took a more negative stance. One person even went so far as to tell Gardam he should have his medical licence revoked.

Gardam says simply beating people over the head with the message that they’re not washing their hands enough isn’t the way to bring about fundamental change.

“When we went around yesterday and handed out our coupons to people, they were really pleased,” Gardam says. “People I think aren’t used to having somebody take them aside and say, ‘hey, we want to thank you for washing your hands. Great job, keep it up.’"

“It really created a buzz on the floor and that’s what I want to do,” he says.

To catch up with more hand hygiene stories from 2007, visit the HIROC News archives.