Why Hand Hygiene Compliance Programs Fail

3 things hospitals need to account for to ensure a successful hand hygiene compliance program

reliance+on+gloves-1Everyone in healthcare knows that washing your hands is critical to preventing the spread of infection in hospitals, which can lead to hospital-acquired infections (HAIs) and even patient death. Such a simple, almost mindless task has very serious implications on patient safety, and the Joint Commission has decided it’s time for hospitals to get serious in addressing this problem, as evidenced by their new standards issued on January 1, 2018.

In the 14 years since the organization introduced the National Patient Safety (NPSG) 07.01.01 in 2004, which outlines the need for healthcare organizations to establish and implement a hand hygiene compliance program, the guidance from the JC - including their own Targeted Solutions Tool (TST)® - hasn’t really helped hospitals from creating hand hygiene compliance programs that fail.


There are three major problem areas where hospitals and healthcare organizations get sidelined in their initiatives:

1. Hand hygiene compliance is a large problem to tackle, and it must become a shared responsibility across the hospital. Consider a single patient in a single room. How many people – physicians, nurses, non-clinical staff – enter and exit this room in a 24 hour period who need to wash or sanitize their hands before going to the next patient’s room? Now take that number of opportunities and multiply it by how many beds are in that hospital, not to mention common areas, etc. The task becomes severely daunting when thinking about how to track all of these opportunities and hold people accountable. There is a tremendous amount of buy-in among both salaried and hourly staff required to adopt any new initiative – hand hygiene will continue to be a struggle without full, top-down support from leaders who make it a high priority.

2. Hand hygiene compliance programs tend to fail because of the manual labor required to execute them. It is a burden on staff who should be focused on actual care and not the administration of real-time behavioral auditing. Peer audits are cumbersome and compromising to overall morale – any situation that requires colleagues to monitor and report each other can lead to favoritism or bias and is rushed rather than methodical. There’s also the Hawthorne effect, a reactive social mechanism that shows when people know they’re being monitored, they perform better than they would if they didn’t know someone was watching.

3. The inaccuracies and unreliableness of manual data collection is what makes today’s compliance programs so ineffective: a lack of insight into where and when compliance is failing leads us to the inability to course correct. The burden to collect all compliance opportunities is compounded by the effort involved to make that data valuable - tabulation, analysis, synthesis, and distribution. In a world where everyone is becoming used to real-time reporting, this “by-eye-and-hand” effort doesn’t cut it anymore.

With a lack of resources already, clinicians are being tasked to produce metrics on a regular cadence; without accurate visibility into performance, setting benchmarks of where hand hygiene compliance is today is impossible. Without a benchmark, hospitals will never know the truth of where behavior and processes need to be changed.

Why hospitals are looking toward electronic hand hygiene monitoring

Electronic hand hygiene monitoring systems utilize location-based events to monitor staff activity across departments, units, or entire hospitals in order to track individual compliance rates at scale. Using SwipeSense, hospitals are seeing increased hand hygiene compliance by collecting data previously unavailable, relieving staff and caregivers from any reporting burden, and providing greater transparency into the data for leadership.

Electronic hand hygiene compliance systems are most effective in hospitals where leadership is mandating behavior change and holding people accountable by setting goals and bonuses tied to performance. Ultimately, executives need to understand how the data ties back to their rate of HAIs and HACs, including all related costs, so they can continue to invest in improving their reputation, staff productivity, and zero-harm initiatives.

It all starts with clean hands, always.

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SwipeSense electronic hand hygiene system can help you create a successful hand hygiene compliance program in your hospital.

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