Programs Hand Hygiene

In 2006-2007 the Clinical Excellence Commission (CEC) conducted the successful Clean Hands Save Lives campaign in all NSW public hospitals. During the campaign, healthcare workers improved their use of alcohol-based hand rub and hand washing. However we can still improve.

Hand Hygiene Initiative

The Australian Commission on Safety and Quality in Health (ACSQHC) has developed a program for achieving high compliance with hand hygiene as defined by World Health Organization (WHO) standards. The full implementation of this program across all public and private hospitals is considered the best opportunity to achieve a substantial reduction in healthcare associated infections across the country.

This will not only save lives but will also reduce costs. The ACSQHC has retained Hand Hygiene Australia (HHA) to lead the National Hand Hygiene Initiative (NHHI) and in March 2009 the CEC commenced the implementation of the National Hand Hygiene Initiative (NHHI) in NSW.

The NHHI provides a clear, systematic and standardised approach to hand hygiene culture-change. The outcome measures for the program are:

1. Increase in Hand Hygiene compliance
2. Reduction in rates of Staphylococcus aureus bacteraemia (SAB)

The goal is to make hand hygiene 'core business' for all healthcare workers.

5 Moments for Hand Hygiene

Simple steps by staff and visitors can help reduce the risk of infection to patients, including practicing hand hygiene:

1. Before touching a patient
2. Before a procedure
3. After a procedure
4. After touching a patient
5. After touching the patient's environment

These 5 points are known as the "5 Moments for Hand Hygiene" promoted by the World Health Organization (WHO) - World Alliance for Patient Safety campaign – "Clean Care is Safer Care" launched in 2005. Australia is part of this international effort to improve hand hygiene.

Key features of the Hand Hygiene Initiative

1. Auditing of Hand Hygiene compliance

   The audits are based on the 5 Moments for Hand Hygiene and will be collected three times each year. The audits focus on ‘5 Moments for hand hygiene' conducted for individual patient care. The CEC and HHA provide the training to credential "Gold Standard" Assessors who will then be able to provide training for clinicians to undertake audits on the wards. The data collected from these audits will contribute to the national data collection and provide the ability to benchmark against other states/ territories and nations. Key staff, considered to be the "subject matter experts" eg Infection Control Practitioners and educators will be trained as "Gold Standard" Assessors. As this is part of a national program this credential is transferable and is considered a significant achievement.

2. Use of alcohol-based hand rub

   Alcohol based hand rub should be placed at the point of care eg the foot of the patient bed. Audits of product accessibility contribute to the improvement activities undertaken to assist improvement in hand hygiene compliance and will be submitted to the CEC periodically through the program.

3. Collection of SAB data

   The rate of Staph aureus bacteraemia (measured as a proportion of occupied bed days and of separations) is the key outcome measure of the initiative. This will include collection of information about antibiotic sensitivity and whether the infection was likely to have been hospital acquired.

4. Education of health care workers

   Over time, all healthcare workers should participate in an education program to improve knowledge about infection prevention and control. An e-learning package has been developed by HHA for this purpose. It is suggested that this program be incorporated into orientation and mandatory training for existing staff.

Messages on Hold

As part of the Clinical Excellence Commission's strategy to encourage hand hygiene, we've created "messages on hold" available for downloading by hospital teams across NSW. Expect to hear them soon if you phone a hospital near you.

• Female voice - MP3 ~332kb
• Male voice - MP3 ~368kb
• Male and female voice - MP3 ~321kb

Please, feel free, even if you don't work in the health system, to use the material. The message is simple. Clean your hands. That saves lives.

ABC News Radio

Doctors having difficulty keeping their hands clean - and are muddying their reputation in the process... Dr Annette Pantle talks to Cathy Bell from ABC News Radio. - Published, October 19 2009

• Read the transcript - PDF ~16kb
• Listen to the audio - MP3, duration 5:25

World Hand Hygiene Day

Global Call for Action on Hand Hygiene Day

Professor Cliff Hughes AO, CEO of the Clinical Excellence Commission gives his simple message to mark Global Call for Action on Hand Hygiene Day, 2009. - Published, May 5 2009

• Global Call for Action on Hand Hygiene Day, 2009

• NSW Health Infection Control home page