Background / Aims: In 2011 ED was included in the ‘National Gold Hand Hygiene’ audit. The target was set at 70%. We achieved a dismal compliance rating of 20%. It was clear EC needed to make fundamental changes in our attitude towards hand hygiene.
Methods: Senior staff was recruited to participate in the quality improvement programme, and hand hygiene champions were established. We identified problems by following the A3 improvement methodology. During the analysis phase, a survey was developed to understand the perceived barriers to compliance. In order to mitigate the issues, ‘Plan, Do, Study, Act’ (PDSA) cycles were implemented. This included availability of hand-gel at point of care, updates for staff, profiled patient stories, and teaching sessions both on and off the floor. We used agar plates to illustrate to EC staff what was growing on their hands and in their environment. Repeat agar plates were used during the following national audits.
Results: The result of the quarterly national gold audit, demonstrates our success. In the March 2016 audit, EC achieved 83% compliance pass rate. One of the unexpected benefits came as a result of the PDSA using the agar plates. This showed we were not just meeting a target, but we actually had cleaner hands in ED.
Conclusions: The key success factors:
• EC took ownership of the issues, and found our own unique way to improve.
• Personal story – Service Manager shared her experience with EC staff on video.
• Culture change towards hand hygiene.
• Agar plates – provided credibility to the campaign.
Furthermore, we have been approached by HQSC and HHNZ, to share our EC hand hygiene experience with other emergency departments. We are extremely proud that we are the first emergency department to participate in the national audit.
Counties Manukau Health