A creative yet simple approach to improve hand hygiene compliance in the pediatric intensive care unit

ISSUE: Hand hygiene (HH) is the single most effective means of preventing healthcare-associated infections. Studies show the average hand hygiene compliance among healthcare workers (HCWs) is 40%. An infection control professional (ICP) conducted 4 months of HH observations without staff awareness in our pediatric intensive care unit (PICU). In this period, the HH compliance in the unit was 44.7% (73 out of 163 observations). PROJECT: The effects of prior HH campaigns in the PICU were limited and short lived. Our goal was to develop an approach to HH that was both effective and longer lasting. HH education was performed by an ICP. A bulletin board reemphasizing the importance of hand hygiene and its impact on reducing the transmission of microorganisms was displayed in the PICU for 2 weeks. Posters were designed with the slogan: “Coming in. Going out. Please WASH your Hands to keep the GERMS OUT.” These included child-friendly pictures and then color enhanced by our pediatric patients. They were permanently placed outside every patient's room. Ongoing HH surveillance is being conducted using the same criteria used in the pre-intervention period. RESULTS: Four months after this initiative, our HH compliance rate increased to 71.8% (116 out of 160 observations). The improved compliance was supported by a 12% increase in the usage of the alcohol-based hand hygiene product. LESSONS LEARNED: Multiple factors facilitated the overall improvement in HH compliance. However, we feel the single most influential one was the design of our posters. The creative yet simplistic “added touch” given to them by our pediatric patients allows their uniqueness to stand out. They provide our staff constant reminders of the importance of hand hygiene. We plan to extend this initiative to include our other three pediatric units.