Measuring Hand Hygiene Adherence

Ruzanna Harutyunyan's picture
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Preventing infections is critical to patient safety. Effective hand hygiene practices have long been recognized as the most important way to reduce the transmission of potentially deadly germs in health care settings. To help health care organizations target their efforts in measuring hygiene performance, The Joint Commission is releasing “Measuring Hand Hygiene Adherence: Overcoming the Challenges.”

The monograph is the result of a two-year collaboration with major infection prevention and control leadership organizations in the United States and abroad to identify effective approaches for measuring adherence to hand hygiene guidelines in health care organizations. In addition to The Joint Commission, the participating organizations include the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the World Health Organization (WHO) World Alliance for Patient Safety, the Institute for Healthcare Improvement (IHI) and the National Foundation for Infectious Diseases (NFID).

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Measuring hand hygiene performance has long been complicated because of the need to monitor the practices of many different care providers in numerous locations for sufficient periods of time. Without standardized approaches to measuring hand hygiene performance, it is impossible to determine whether overall performance is improving, deteriorating or unchanged as new strategic interventions are introduced. The Joint Commission’s National Patient Safety Goals require accredited organizations to follow recognized hand hygiene guidelines; however, studies continue to show that adherence to these guidelines is lacking. This is due, in part, to the variation in approaches to measurement, which makes rates of adherence difficult to compare.

The monograph provides a framework to help health care workers make necessary decisions about when, why and how to measure compliance with hand hygiene. The monograph systematically reviews the strengths and weaknesses of commonly used approaches. Examples of measurement methods and tools in the monograph, which also includes references to evidence-based guidelines and published literature, were submitted by organizations through the Consensus Measurement in Hand Hygiene project. The project was supported by an unrestricted educational grant from GOJO Industries, Akron, Ohio.

“Measuring hand hygiene adherence is not a simple matter,” says Jerod M. Loeb, Ph.D., executive vice president, Division of Quality Measurement and Research, The Joint Commission. “The monograph can help health care organizations more effectively measure compliance and strengthen improvement activities that save lives and money.”

“Monitoring hand hygiene is useful only if the methods are valid and reliable and the results are widely disseminated and used to improve practice,” says Elaine Larson, R.N., Ph.D., F.A.A.N., C.I.C., scientific advisor for the project and associate dean for research at the Columbia University School of Nursing, New York. “This Monograph will be an invaluable resource to institutions struggling to do it right.”

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