291 / Hand hygiene compliance observations between co-workers

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Implementation of Patient Safety initiatives / Activities
There is no specified text here There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
The aim was to improve hand hygiene compliance in an intensive care unit (ICU).
Description of the Patient Safety Practice
 
ICU's nurses do direct observations across short time periods (about ten minutes), during leisure time across his/her working shift. The WHO Observation Form is used. A Preventive Service member analyzes a report results each one or two month, stratifying compliance by opportunity type and professional category. We start from a very low compliance rate and reach near 80% compliance. We know all the observations are biased, and probably the true rate is not so high, but this bias does not affect the growing rate we have noticed. At the same time we have observed a decrease in cross infection rates, mainly in catheter related bacteriaemia.
There are two main reasons to explain the increase of hand hygiene compliance. First the Hawthorne effect: ICU's health professionals know they can be observed at any time, but also ICU nurses are strongly involved in the observation project, so they are more aware of Hand Hygiene opportunities.

Training sessions were included into preventive service activities and performed by preventive staff, so there was no additional cost other than observation forms photocopies

Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
We have shown results only in national meetings.
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of incentive
Lack of knowledge on implementation strategies
No motivation among staff
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
For observer nurses we certify participation in a Hand Hygiene improvement project, this was a certificate valid for professional career. Also, from the preventive service, we help nurses to show results in several professionals meetings and there was a scientific paper in preparation with all the observer nurses as co-authors.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Yes
Total number of person days required to implement this Patient Safety Practice
Clinical staff: 0
External consultants: 0
Support staff: 0
Managerial staff: 0
Others: 0
Not relevant: 0
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: 7
External consultants: 0
Support staff: 0
Managerial staff: 0
Others: 0
Not relevant: 0
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
0
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
0
Contact information
 
Name: Aurora Bueno-Cavanillas
Country: SPAIN
Organisation: Hospital Universitario San Cecilio, Andalusia
E-mail: abueno@ugr.es
Phone: 34 958248855
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