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Comprehensive Approach to Hand Hygiene

Diverse Business Group Senior Asian Couple
Thursday, January 10, 2019

Hoag Orthopedic Institute in Irvine, California, is committed to providing patients with a safe and healing environment. Hand hygiene is a simple yet effective way to prevent infections. Achieving and sustaining high hand hygiene compliance has been identified as a core organization-wide quality care goal.

Several strategies were developed to support their healthcare providers in reaching this goal, beginning with the creation of a fully-trained multidisciplinary Hand Hygiene Observer program (secret shoppers). These observations are submitted to infection prevention for analysis and reporting at staff, committee, and leadership meetings.

It quickly became apparent that incorporating appropriate hand hygiene into patient-care workflows, especially in the perioperative area, required removal of product access barriers. To this end, optimizating location and quantity of hand hygiene dispensers in patient bays in the pre-operative (Pre-op) area and Post-Anesthesia Care Unit (PACU) along with the Operating Room (OR) proved beneficial. Pre-op/PACU areas have the challenge of limited wall space to place the dispensers, which was solved through the use of clamped bedside-table hand hygiene gel-dispenser holders placing the product directly at the point of care.

Blinded, individualized, annual hand hygiene compliance feedback to surgeons and anesthesiologists was posted. Frequently asked questions (FAQ’s) describing hand hygiene observations were developed for inpatient, OR, and anesthesia work areas.

The internal efforts are complemented with targeted education of patients and families including pre-hospitalization education in the pre-op patient materials—a video on hand hygiene for patients and families—hand sanitizer/wipes on the food trays—the permission to ask if the caregiver is not seen to wash their hands upon entry to the room. 

For more information, please contact Patti Steger, BS, CLS, MT(ASCP), CIC, Manager of Infection Prevention, Hoag Orthopedic Institute, at