Why a Hand Hygiene Audit is so Important
A hand hygiene audit is carried out in healthcare facilities to assess the hand hygiene compliance in healthcare workers. The hand hygiene audit tool aims to prevent the spread of infections between staff and patients as far as possible, utilizing observation controls.
Although easily preventable, infections transmitted in the course of standard patient care are still one of the leading causes of death and disability worldwide – with over 1.4 million cases a year that can occur at any time. The simplest and most effective countermeasure is for healthcare professionals to correctly apply hand hygiene techniques during the five moments of patient care.
Regular hand hygiene audits in hospitals and other healthcare facilities are an essential part of successful infection control.
This article discusses:
Why a hand hygiene audit is important in healthcare
About 90 percent of all nosocomial infections in healthcare are due to poor hand hygiene by nurses and physicians. In theory, everyone knows that hand hygiene is extremely important, but there are three critical reasons that prevent thorough hand disinfection:
- Time constraints
- Allergic reactions to the disinfectant
- Lack of awareness of the problem
Hospital employees’ hands are usually the transmitters of microorganisms from a contaminated or infected body site (e.g., via blood or other body fluids) to a primarily noncolonized, i.e., “clean” or sterile site. In this context, transmission can occur from patient to patient, from a contaminated environment to a patient, or from patient and/or environment to staff.
During patient care, staff hands are increasingly colonized with microorganisms, including potential pathogens. Accordingly, the degree of colonization of the hands increases the longer the work on the patient lasts – if adequate hygienic hand disinfection is not performed. In addition, disposable gloves are also frequently not used properly.
One-third of nosocomial infections could be prevented by good and consistent hand hygiene. However, studies show that, on average, hygienic hand disinfection occurs in only half of the required situations in healthcare settings. In critical situations with high work density and time as well as personnel bottlenecks, the Compliance sinks soar still. This is why it is so important to conduct hand hygiene audits at regular intervals in all healthcare settings. To significantly reduce nosocomial infection rates through improved hygienic hand disinfection.
How to effectively conduct a hand hygiene audit
The World Health Organization (WHO) recommends that the following points be observed during hand hygiene audits in the health care system:
1. Communicate with the institution
Contact the hospital administration before the audit begins. State the observation period, and the purpose for implementing hand hygiene monitoring systems in the hospital. Inform the health personnel about the type of data documentation (e.g. utilizing photo documentation).
2. Define the audit areas
All areas in which patient care is regularly provided are audited. Introduce yourself to the head nurse, the head physician of the department or the head of the department and explain your observational function. Try to gather a range of information across the different wards and departments.
3. Protect the privacy of the patient
The privacy of patients must not be compromised during the audit. Obtain the written consent of the patient if necessary. Audits must not be conducted during extreme situations (e.g. emergency medical treatment, signs of uncontrolled stress in a health care employee).
4. Observe individual HCPs
Perform the audit according to the WHO 5 moments of hand hygiene:
BEFORE patient contact
BEFORE aseptic activities
AFTER contact with potentially infectious material
AFTER patient contact
AFTER contact with the direct patient environment
5. Document and share the main results
Communicate your feedback to the medical staff on the implementation of hand hygiene. Compliance scores are determined by the ratio of the number of actions (hand hygiene) performed to the number of opportunities (moments). Share your results with management, department heads, board members and staff who primarily have patient contact.
A digital tool for the hand hygiene audit
Lumiform’s mobile app helps you comply with RKI hand hygiene guidelines with ease. Facilitate data collection and reporting as a healthcare auditor with a digital solution for your inspections.
Carrying out a hand hygiene audit the old way with the help of analog checklists is a challenge with weak points and loss of information. Tracking improvements, making updates, and implementing measures is easier with a digital application. Besides, training and preventive measures can be implemented more easily by sharing all information digitally with all employees.
In summary, the most important functions of the hand hygiene audit app are:
- Perform simple hand hygiene audits on a mobile device.
- Capture and store unlimited hand hygiene photos and observations.
- Automatic tracking of compliance scores according to the 5 moments of hand hygiene.
- Immediate analysis and feedback of critical results are available before leaving the facility.
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